Individual
MR. GREGORY G HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
243 WOODROW WILSON AVE, FISHERSVILLE, VA 22939
(540) 332-7087
Mailing address
PO BOX 1500, BOX W-1, FISHERSVILLE, VA 22939-1500
(540) 332-7087
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003689
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004980107
—
VA
Enumeration date
09/20/2006
Last updated
08/27/2019
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