Individual
MIRANDA HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
10021 ABERDEEN LN, YUKON, OK 73099-7644
(405) 474-4417
Mailing address
10021 ABERDEEN LN, YUKON, OK 73099-7644
(405) 474-4417
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
644
OK
Other
Enumeration date
01/27/2016
Last updated
06/30/2017
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