Evan Mikel Hagen, ATC, PTA
NPI #1356693634 in Lacey, Washington
Provider Information
- NPI Number
- 1356693634
- Entity Type
- Individual
- Name
- Evan Mikel Hagen, ATC, PTA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Credential
- ATC, PTA
- Enumeration Date
- Oct 10, 2012
- Last Updated
- Oct 10, 2012
Practice Location
- Address
- 2610 GREENLAWN ST SE
- City
- Lacey
- State
- Washington
- ZIP Code
- 98503-3736
- Phone
- (360) 701-4573
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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