Individual
CHRISTOPHER HAGEDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5315 ELLIOTT DR, YPSILANTI, MI 48197-8634
(734) 712-3563
Mailing address
3145 W CLARK RD, YPSILANTI, MI 48197-1120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501018228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501018228
MICHIGAN STATE LICENSE
MI
Enumeration date
11/01/2017
Last updated
11/01/2017
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