Individual
KATELYN LANE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
600 MARKET ST STE 190, CHANHASSEN, MN 55317-4572
(952) 937-9465
Mailing address
8300 OAK DR, VICTORIA, MN 55386-8230
(605) 695-2084
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3615
MN
Other
Enumeration date
06/06/2019
Last updated
08/07/2024
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