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NPI Code Detail

MEDICARE: EMILY HANSEN PT

MEDICARE:   EMILY  HANSEN  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist12247PTAZ

General Provider Information

NPI Number : 1649628652
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY HANSEN PT
Provider Business Mailing Address
First Line : 245 E BELL RD
Second Line : SUITE 58
City : PHOENIX
State : AZ
Zip : 85022-2353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 245 E BELL RD
Second Line : SUITE 58
City : PHOENIX
State : AZ
Zip : 85022-2353
Country : US
Telephone Number : 602-843-8486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2016
Last Update Date : 08/22/2017

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Directions to “ EMILY HANSEN PT” Practice Location

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