Individual
LORRAINE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 LAUREL AVE, KEANSBURG, NJ 07734-1125
(732) 787-8100
Mailing address
25 THOROUGHBRED FARE, TINTON FALLS, NJ 07753-7524
(732) 610-2544
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00269000
NJ
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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