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General NPI Number Information
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NPI Number | 1083691224
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Entity Type | Individual
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Provider Name | MICHELLE A HAGER PT
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7011 W CENTRAL AVE SUITE 125
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City | WICHITA
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State | KS
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Zip | 67212-3386
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Country | US
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Telephone | 316-946-9662
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Fax | 316-946-9745
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Provider Business Mailing Address
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Address Line | 801W PUTTER
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City | ANDOVER
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State | KS
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Zip | 67002
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Country | US
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Telephone | 701-330-0866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11-03515
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License Number State | KS
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