Hagen Chiropractic, LTD.

Organization Active NPI Clinic/Center · Green Lake, WI

NPI 1740518554 · NPPES record last updated Dec 7, 2009

Key facts

NPI
1740518554
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
License
4507-012 (WI)
Legal business name
HAGEN CHIROPRACTIC, LTD.
Practice address
529 Mill St
Green Lake, WI 54941-9425
Phone
(920) 294-4357
NPI assigned
Dec 7, 2009
Organization subpart
No

Authorized official

Name
Dr. Ethan H Hagen, D.C.
Title
President
Phone
(920) 294-4357

National Provider Directory

Locations

529 Mill St
Green Lake, WI 54941
Phone (920) 294-4357

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4507-012 WI Yes

Addresses

Primary practice location

529 Mill St
Green Lake, WI 54941-9425

Mailing address

PO Box 336
Green Lake, WI 54941-0336
Phone (920) 294-4357

Other providers in Green Lake, WI

All providers in Green Lake, WI · Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.