Individual
JAY HANSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
621 SCIENCE DR, MADISON, WI 53711-1074
(608) 513-5206
Mailing address
5212 SUMMER TRAIL RD, MC FARLAND, WI 53558-9667
(608) 838-6887
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
354-039
WI
Other
Enumeration date
09/30/2005
Last updated
07/08/2007
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