Individual
KELLI HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
221 HIGHWAY 53, SUITE D, COOK, MN 55723-5102
(218) 666-2697
Mailing address
8757 JOHNSON RD, ANGORA, MN 55703-8141
(218) 750-7654
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4894
MN
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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