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1740957943
ELLIE HAGEN
FARGO, ND
NPI
1740957943
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: ND 2570)
Enumeration Date
2021-08-25
Last Update Date
2021-08-25
Business Address
ELLIE HAGEN
737 BROADWAY N
FARGO, ND 58102-4421
Phone number: 701-234-5932
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Mailing Address
ELLIE HAGEN
737 BROADWAY N
FARGO, ND 58102-4421
Phone number: 701-234-5932
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