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Individual

DANIEL HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18432 KENRICK AVE, LAKEVILLE, MN 55044
(952) 993-8800
Mailing address
18432 KENRICK AVE, LAKEVILLE, MN 55044-9288
(952) 993-8800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
65984
MN
207Q00000X
Family Medicine Physician
R-10701
IA

Other

Enumeration date
07/09/2016
Last updated
08/14/2019
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