Individual
MR. TYLER HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
775 PRAIRIE CENTER DR, EDEN PRAIRIE, MN 55344-7314
(952) 944-5314
(952) 944-0092
Mailing address
775 PRAIRIE CENTER DR, EDEN PRAIRIE, MN 55344-7314
(952) 944-5314
(952) 944-0092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2174
MN
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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