Individual
KENNETH DAVID HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15936 E HIGHWAY 40, SILVER SPRINGS, FL 34488-5144
(352) 625-0135
Mailing address
3705 SE 48TH ST, OCALA, FL 34480-7385
(352) 622-3711
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 1542
FL
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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