Organization
HANSEN NEUROPSYCHIATRIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL R HANSEN JR. M.D. (PRESIDENT)
(952) 920-6100
Entity
Organization
Contact information
Practice address
4601 EXCELSIOR BLVD, SUITE 300, ST LOUIS PARK, MN 55416-4960
(952) 920-6100
Mailing address
4601 EXCELSIOR BLVD, SUITE 300, ST LOUIS PARK, MN 55416-4960
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1103
MN
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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