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Organization

HANSON GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLASS E HANSON ODP (OWNER)
(208) 356-0881
Entity
Organization

Contact information

Practice address
24 E MAIN ST, REXBURG, ID 83440-1927
(208) 356-0881
Mailing address
PO BOX 547, REXBURG, ID 83440-0547

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-703
ID

Other

Enumeration date
01/25/2012
Last updated
04/25/2012
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