Organization
FALLON HAGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FALLON HAGY (OWNER)
(717) 327-6574
Entity
Organization
Contact information
Practice address
7332 WYOMING TRL, WYOMING, MN 55092-9343
(717) 327-6574
(651) 408-9303
Mailing address
7332 WYOMING TRL, WYOMING, MN 55092-9343
(717) 327-6574
(651) 408-9303
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
1082496
MN
Other
Enumeration date
09/13/2016
Last updated
09/23/2016
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