Individual
LISA HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3501 N BUTLER AVE STE 101, FARMINGTON, NM 87401-6430
(505) 326-0064
Mailing address
3501 N BUTLER AVE STE 101, FARMINGTON, NM 87401-6430
(505) 326-0064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-016903
IL
225100000X
Physical Therapist
4043
NM
225100000X
Physical Therapist
6540
SC
Other
Enumeration date
02/13/2009
Last updated
10/17/2011
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