Individual
MRS. LORI LOUISE HAGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 995-3744
Mailing address
6609 N 42ND ST, OMAHA, NE 68112-2908
(402) 350-3030
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
NE
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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