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Individual

DR. THOMAS JACK HANSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
702 5TH ST NW, BEMIDJI, MN 56601-2976
(218) 751-9533
(218) 444-4759
Mailing address
702 5TH ST NW, BEMIDJI, MN 56601-2976
(218) 751-9533
(218) 444-4759

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1307
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1N075HA
BCBC MN
MN
01
230313
ACN GROUP
MN
Enumeration date
06/28/2005
Last updated
07/08/2007
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