Individual
GEORGE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1061 HARMON AVE, FT STEWART, GA 31314
(912) 435-6580
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
251533
OH
163W00000X
Registered Nurse
Primary
4704193595
MI
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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