Individual
TERRY HAUGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 DEER PATH CT, ETNA, OH 43062-6004
(614) 406-4627
Mailing address
122 DEER PATH CT, ETNA, OH 43062-6004
(614) 406-4627
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
177F00000X
Lodging Provider
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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