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Organization
HAGEN CLINIC PLLC
Active
Organization
HAGEN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD M HAGEN D.C. (OWNER)
(563) 449-8153
Entity
Organization
Contact information
Practice address
2395 TECH DRIVE, SUITE 3, BETTENDORF, IA 52722-3277
(563) 449-8153
(563) 449-8154
Mailing address
2395 TECH DRIVE, SUITE 3, BETTENDORF, IA 52722-3277
(563) 449-8153
(563) 449-8154
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06839
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649395054
MEDICARE NPI
IA
01
—
I17012
MEDICARE PTAN
IA
Enumeration date
12/12/2013
Last updated
12/12/2013
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