Individual
JUSTIN D HAGEDORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 N MAIN ST, WICHITA, KS 67202-1501
(316) 425-7717
Mailing address
8918 W. 21ST ST. N., SUITE 200, #198, WICHITA, KS 67205
(316) 425-7717
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
11/30/2021
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