Individual
BENJAMIN HAGGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
730 LAKE DR SE, GRAND RAPIDS, MI 49503-4435
(231) 301-0384
Mailing address
730 LAKE DR SE, GRAND RAPIDS, MI 49503-4435
(231) 301-0384
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001235
MI
Other
Enumeration date
03/17/2014
Last updated
04/28/2014
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