Individual
KEVIN O'HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 EAST AVE, ROCHESTER, NY 14610-1822
(631) 942-6208
Mailing address
24 SISSON DR, ROCHESTER, NY 14623-4320
(631) 942-6208
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
013257
NY
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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