Individual
MR. MILES DOUGLAS HANSEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10 DALEY RD, POUGHKEEPSIE, NY 12603-3225
(845) 546-2286
Mailing address
10 DALEY RD, POUGHKEEPSIE, NY 12603-3225
(845) 546-2286
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002176
NY
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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