Laurel Ann Hagensick, PT
Individual provider Active NPI Physical Therapist · Waukon, IA
NPI 1376677211 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376677211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 03409 (IA)
- Practice address
- 40 1St St SE
Waukon, IA 52172-2022 - Phone
- (563) 568-3411
- Fax
- (563) 568-5699
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03409 | IA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 03409 | IA | Yes |
Addresses
Primary practice location
40 1St St SE
Waukon, IA 52172-2022
Mailing address
202 Eagle Dr
MC Gregor, IA 52157-8515
Phone (563) 873-2542
Other providers in Waukon, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.