DWAYNE PATRICK HAGENOW

COS COB, CT
NPI1184134025
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: CT  54.001127)
Enumeration Date2017-10-05
Last Update Date2017-10-05
Business Address
DWAYNE PATRICK HAGENOW
35 RIVER RD STE 2
COS COB, CT 06807-2759
Phone number: 203-422-0679
Mailing Address
DWAYNE PATRICK HAGENOW
35 RIVER RD STE 2
COS COB, CT 06807-2759
Phone number:
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