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Individual

MR. RYAN C HANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
2006 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-4622
(605) 342-3110
(605) 342-3120
Mailing address
2006 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-4622
(605) 342-3110
(605) 342-3120

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1415
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467613364
WELLMARK BCBS
SD
05
5836570
SD
Enumeration date
06/23/2008
Last updated
09/08/2008
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