Individual
DERICK WILLIAM HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1686 LEXINGTON AVE N, ROSEVILLE, MN 55113-6514
(877) 609-0123
(888) 425-0398
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13095
MN
Other
Enumeration date
06/07/2023
Last updated
06/08/2023
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