Individual
TYLER HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2550 ADDISON AVE E STE D, TWIN FALLS, ID 83301-6749
(208) 814-7700
Mailing address
511 MAGNOLIA AVE, TWIN FALLS, ID 83301-6210
(208) 490-0035
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTL- 1765
ID
Other
Enumeration date
05/11/2017
Last updated
02/12/2018
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