MEDICARE: MRS. CHANTEL L. HASMAN MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	10530-024	WI

General Provider Information

NPI Number	:	1689688533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHANTEL L. HASMAN MPT

Provider Business Mailing Address
First Line	:	944 WATER ST
Second Line	:
City	:	SAUK CITY
State	:	WI
Zip	:	53583-1535
Country	:	US
Telephone Number	:	608-643-3495
Fax Number	:	608-643-6719

Provider Business Practice Location Address
First Line	:	944 WATER ST
Second Line	:
City	:	SAUK CITY
State	:	WI
Zip	:	53583-1535
Country	:	US
Telephone Number	:	608-643-3495
Fax Number	:	608-643-6719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	06/25/2008

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