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Individual

MISS KAITLYN ELIZABETH HAGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 DENT DR, LEWISBURG, PA 17837
(570) 577-1706
Mailing address
1 DENT DR, LEWISBURG, PA 17837-2029
(570) 577-1706

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005279
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31024
NATA
Enumeration date
03/06/2014
Last updated
09/18/2019
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