Individual
AMY HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
(920) 794-5000
Mailing address
5000 MEMORIAL DR, TWO RIVERS, WI 54241-3900
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1037-39
WI
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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