Individual
BRIAN WILLIAM HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
N6719 HIGHWAY 42, ALGOMA, WI 54201-9703
(920) 559-2373
Mailing address
N6719 HIGHWAY 42, ALGOMA, WI 54201-9703
(920) 559-2373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R7690
WI
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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