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General NPI Number Information
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NPI Number | 1073618773
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Entity Type | Individual
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Provider Name | JAN HANSON PT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 670 COMMERCE DR STE 140
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City | WOODBURY
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State | MN
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Zip | 55125-9290
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Country | US
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Telephone | 651-501-2010
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Fax | 651-436-6775
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Provider Business Mailing Address
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Address Line | 1325 SCHOONER CT
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City | WOODBURY
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State | MN
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Zip | 55125-9295
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Country | US
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Telephone | 651-436-2362
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Fax | 651-730-1121
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 885
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License Number State | MN
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