Benjamin G Hagen, MPT Valid NPI
Individual provider · Physical Therapist · O Fallon, MO
- NPI
- 1922392448
- Type
- Individual (Type 1)
- Primary specialty
- Physical Therapist
- Specialty group
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Taxonomy code
- 225100000X
- License number
- 2011014886 (MO)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2011-06-01
- Last updated
- 2011-06-01
Practice location
9331 Phoenix Village Pkwy
O Fallon, MO 63368-4281
(636) 561-4793