Individual
GLEN THOMAS HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
10581 ROSELLE ST, SAN DIEGO, CA 92121-1519
(858) 258-9493
Mailing address
4665 GOLDENROD LN N, MINNEAPOLIS, MN 55442-2493
(161) 275-1210
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
12/27/2023
Last updated
12/27/2023
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