Organization
KIRK HANSON
Active
Organization
KIRK HANSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRK EDWARD HANSON (CEO)
(612) 720-3824
Entity
Organization
Contact information
Practice address
19679 CALGARY TRL, FARMINGTON, MN 55024-1488
(612) 720-3824
(888) 546-6978
Mailing address
PO BOX 21715, EAGAN, MN 55121-0715
(612) 720-3824
(888) 546-6978
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
MN
335G00000X
Medical Foods Supplier
—
MN
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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