Individual
MR. LOWELL B HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 ENTERPRISE AVE NE, ISANTI, MN 55040-6813
(763) 552-6161
Mailing address
4 ENTERPRISE AVE NE, ISANTI, MN 55040-6813
(763) 552-6161
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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