MEDICARE: REBECCA HAIGHT PT

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	2934-024	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942267638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA HAIGHT PT

Provider Business Mailing Address
First Line	:	3229 OLD FOX RUN
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-9484
Country	:	US
Telephone Number	:	608-837-0774
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 ELLIS POTTER CT
Second Line	:	SUITE 200
City	:	MADISON
State	:	WI
Zip	:	53711-2478
Country	:	US
Telephone Number	:	608-204-6242
Fax Number	:	608-204-6249

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	07/08/2007

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Directions to “ REBECCA HAIGHT PT” Practice Location

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