Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 04669 | IA |
N | 111NN0400X | Neurology | 04669 | IA |
NPI | 1750382107 |
---|---|
Provider Name | Dr. Dennis Steven Hagemann |
First Address | Davenport, IA 52804-2674 |
Second Address | Davenport, IA 52804-2674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 08/07/2007 |