Individual
CONNOR JAMES HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8890 E 116TH ST STE 130, FISHERS, IN 46038-2856
(317) 621-6740
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7547
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013747A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05013747A
STATE LICENSE
IN
Enumeration date
07/14/2020
Last updated
03/22/2022
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