Individual
MR. JEFFREY JAMES DAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
204 LEWIS AVE S, SUITE 210, WATERTOWN, MN 55388-4500
(952) 955-2242
(952) 955-2010
Mailing address
2836 WHITE EAGLE DR, WOODBURY, MN 55129-4291
(952) 955-2242
(952) 955-2010
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4502
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21F00DA
BCBS MN
MN
01
—
HP43366
HEALTH PARTNERS
MN
Enumeration date
04/23/2007
Last updated
07/08/2007
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