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General NPI Number Information
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NPI Number | 1194232884
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Entity Type | Individual
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Provider Name | BRETT HAGER DPT
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Gender | Male
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 20250 N 75TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-7935
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Country | US
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Telephone | 623-432-9965
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Fax | 623-243-7646
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Provider Business Mailing Address
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Address Line | 15508 W BELL RD., SUITE 101, PMB 210
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City | SURPRISE
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State | AZ
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Zip | 85374
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Country | US
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Telephone | 623-432-9965
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Fax | 623-243-7646
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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 | 13556
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License Number State | AZ
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