| Hagen Chiropractic, Ltd. | |
|
529 Mill St Green Lake WI 54941-9425 | |
| (920) 294-4357 | |
| Not Available |
| Full Name | Hagen Chiropractic, Ltd. |
|---|---|
| Speciality | Clinic/center |
| Location | 529 Mill St, Green Lake, Wisconsin |
| Authorized Official Name and Position | Ethan H Hagen (PRESIDENT) |
| Authorized Official Contact | 9202944357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hagen Chiropractic, Ltd. Po Box 336 Green Lake WI 54941-0336 Ph: (920) 294-4357 | Hagen Chiropractic, Ltd. 529 Mill St Green Lake WI 54941-9425 Ph: (920) 294-4357 |
| NPI Number | 1740518554 |
|---|---|
| Provider Enumeration Date | 12/07/2009 |
| Last Update Date | 12/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740518554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4507-012 (Wisconsin) | Primary |
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