| Hagen Chiropractic Clinic Prof LLC | |
|
3405 S Kiwanis Ave Sioux Falls SD 57105-4213 | |
| (605) 361-6824 | |
| (605) 333-0441 |
| Full Name | Hagen Chiropractic Clinic Prof LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3405 S Kiwanis Ave, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Mark Palmer Hagen (OWNER) |
| Authorized Official Contact | 6053616824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hagen Chiropractic Clinic Prof LLC 3405 S Kiwanis Ave Sioux Falls SD 57105-4213 Ph: (605) 361-6824 | Hagen Chiropractic Clinic Prof LLC 3405 S Kiwanis Ave Sioux Falls SD 57105-4213 Ph: (605) 361-6824 |
| NPI Number | 1194867846 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 08/18/2014 |
| Medicare PECOS PAC ID | 6800960972 |
|---|---|
| Medicare Enrollment ID | O20080807000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194867846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 769 (South Dakota) | Primary |
| Provider Name | Mark P Hagen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033190293 PECOS PAC ID: 5092889162 Enrollment ID: I20080807000270 |
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