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General NPI Number Information
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NPI Number | 1982756698
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Entity Type | Individual
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Provider Name | LAURA A. HANSEN OPTICIAN
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 755 GOLD HILL PL
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City | WOODLAND PARK
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State | CO
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Zip | 80863
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Country | US
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Telephone | 719-686-9343
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Fax | 719-686-9342
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Provider Business Mailing Address
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Address Line | 477 PINECREST RD
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City | WOODLAND PARK
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State | CO
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Zip | 80863-8432
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Country | US
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Telephone | 719-686-9343
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Fax | 719-686-9342
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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