Provider Demographics
NPI:1003305244
Name:ROCK, HAILEY G (ATC)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:G
Last Name:ROCK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 THAYER ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54015-9741
Mailing Address - Country:US
Mailing Address - Phone:715-821-1517
Mailing Address - Fax:
Practice Address - Street 1:1240 THAYER ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:WI
Practice Address - Zip Code:54015-9741
Practice Address - Country:US
Practice Address - Phone:715-821-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer