Individual
BRENDAN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
10500 MONTGOMERY RD, MONTGOMERY, OH 45242-4402
(513) 865-1111
Mailing address
1600 BRANDON DR, HEBRON, KY 41048-9571
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2025
Last updated
06/18/2026
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