Doctor Name: | BENJAMIN G HAGEN |
NPI Number: | 1922392448 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | 2011014886 |
Business Practice Address: | 9331 Phoenix Village Pkwy O Fallon, MO - 633684281 |
Business Phone Number: | 6365614793 |
Business Fax Number: | 6365614811 |
Mailing Address: | 2454 W Clay St, SAINT CHARLES |
State: | MO |
Postal Code: | 633012548 |
Phone Number: | 6369164625 |
Fax Number: | 6369164628 |
NPI Enumeration Date: | 06/01/2011 |
NPI Last Update Date: | 06/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2011014886 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |