| NPI | 1912271255 |
|---|---|
| Doing Business As | GREGORY B HAGEDORN |
| Entity Type | Organization |
| Authorized Contact | GREGORY BRENT HAGEDORN Doctor 270-826-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KY 1016DT) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |