Individual
DR. JON HAGENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DA
Contact information
Practice address
45 EAGLE ST, BLDG J, UNIT 100, PROVIDENCE, RI 02909-1011
(401) 323-2998
Mailing address
45 EAGLE ST, BLDG J, UNIT 100, PROVIDENCE, RI 02909-1011
(401) 323-2998
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
DA00279
RI
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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