Individual
MR. THEODORE T HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PARAMEDIC
Contact information
Practice address
1343 BAILEYS COR, MARIETTA, GA 30062-2072
(404) 444-3040
Mailing address
1343 BAILEYS COR, MARIETTA, GA 30062-2072
(404) 444-3040
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
P012395
GA
Other
Enumeration date
08/18/2021
Last updated
08/19/2021
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