Individual
GLENN A HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2331 S ONEIDA ST, GREEN BAY, WI 54304-5267
(920) 499-1177
(920) 499-5398
Mailing address
2331 S ONEIDA ST, GREEN BAY, WI 54304-5267
(920) 499-1177
(920) 499-5398
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
403-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43217500
—
WI
Enumeration date
08/01/2006
Last updated
03/26/2010
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