Individual
JAN HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
670 COMMERCE DR STE 140, WOODBURY, MN 55125-9290
(651) 501-2010
(651) 436-6775
Mailing address
1325 SCHOONER CT, WOODBURY, MN 55125-9295
(651) 436-2362
(651) 730-1121
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
885
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034M0HA
MN BCBS
MN
05
—
139319700
—
MN
01
—
487001000
US DEPT OF LABOR
MN
01
—
6403663
MEDICA
MN
Enumeration date
09/14/2006
Last updated
12/28/2023
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