Provider Demographics
NPI:1689963381
Name:HAGER, AMY SUE (DC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUE
Last Name:HAGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6175 SOM CENTER RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2965
Mailing Address - Country:US
Mailing Address - Phone:440-248-5070
Mailing Address - Fax:440-498-4620
Practice Address - Street 1:6175 SOM CENTER RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2965
Practice Address - Country:US
Practice Address - Phone:440-248-5070
Practice Address - Fax:440-498-4620
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor