Individual
JORDAN HAGENBUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 KENWOOD AVE, DULUTH, MN 55811-4199
(715) 297-7216
Mailing address
133 SUMMIT ST APT 417, DULUTH, MN 55803-4525
(715) 297-7216
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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