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General NPI Number Information
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NPI Number | 1306900063
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Entity Type | Organization
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Legal Business Name | JANINE HANSON DBA JANINE HANSON RPT
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8130 66TH ST SUITE #12
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2111
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Country | US
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Telephone | 727-541-2091
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Fax | 727-545-0503
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Provider Business Mailing Address
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Address Line | 8130 66TH ST SUITE #12
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2111
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Country | US
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Telephone | 727-541-2091
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Fax | 727-545-0503
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Authorized Official
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Title or Position | OWNER
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Name | JANINE HANSON
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Credential | RPT
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Telephone | 727-541-2091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | ST 1245
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License Number State | FL
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