Organization
HAGEN CHIROPRACTIC, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN H HAGEN D.C. (PRESIDENT)
(920) 294-4357
Entity
Organization
Contact information
Practice address
529 MILL ST, GREEN LAKE, WI 54941-9425
(920) 294-4357
Mailing address
PO BOX 336, GREEN LAKE, WI 54941-0336
(920) 294-4357
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4507-012
WI
Other
Enumeration date
12/07/2009
Last updated
12/07/2009
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