Individual
ERIC ROBERT HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSAT, ATC
Contact information
Practice address
14545 PRINCETON AVE, SAVAGE, MN 55378-2774
(612) 384-1623
Mailing address
14545 PRINCETON AVE, SAVAGE, MN 55378-2774
(612) 384-1623
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UUA216A24781
BLUECROSS BLUESHIELD
MN
Enumeration date
01/14/2019
Last updated
08/05/2020
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