Individual
MRS. DIANE WENDY HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T
Contact information
Practice address
3845 W 4700 S, TAYLORSVILLE, UT 84118-3454
(801) 840-2191
(801) 840-2197
Mailing address
12088 MARGARET ROSE DR, RIVERTON, UT 84065-4052
(801) 232-9242
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5148443-2401
UT
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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