Doctor Name: | MR. R. EMIL HAGMAN |
NPI Number: | 1295937902 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | S.560 |
Business Practice Address: | 1325 Cameron Ave Lewis Center, OH - 430359662 |
Business Phone Number: | 6148883972 |
Business Fax Number: | 6148883709 |
Mailing Address: | 1325 Cameron Ave, LEWIS CENTER |
State: | OH |
Postal Code: | 430359662 |
Phone Number: | 6148883972 |
Fax Number: | 6148883709 |
NPI Enumeration Date: | 06/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | S.560 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |