Diana Lynn Haertel
Technician/Technologist, Optician in Portage, WI. Individual provider (NPI-1).
NPI number1104264233
StatusActive
Last updated in NPPESJun 11, 2013
Details
- NPI
- 1104264233
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Diana Lynn Haertel
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2013
- Last updated
- Jun 11, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | – | – | Yes |
Practice location
215 W Cook StPortage, WI 53901-2105
Phone 608-742-2020
Mailing address
215 W Cook StPortage, WI 53901-2105
Phone 608-742-2020
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