MEDICARE: MRS. COURTNEY T HANSON 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
1	225100000X	Physical Therapist	2257PT	MT

General Provider Information

NPI Number	:	1730496142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY T HANSON PT

Provider Business Mailing Address
First Line	:	3036 OLD BROADWATER LN
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-6648
Country	:	US
Telephone Number	:	406-370-5042
Fax Number	:

Provider Business Practice Location Address
First Line	:	3036 OLD BROADWATER LN
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-6648
Country	:	US
Telephone Number	:	406-370-5042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2010
Last Update Date	:	01/30/2012

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