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Individual

WENDY R HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA, EMT-B

Contact information

Practice address
823 M ST, TEKAMAH, NE 68061-1427
(402) 374-1414
(402) 374-1601
Mailing address
100 DIAMOND ST, ONAWA, IA 51040-1929
(712) 423-1620

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
B-12-229-11
IA
225200000X
Physical Therapy Assistant
00646
IA
225200000X
Physical Therapy Assistant
Primary
926
NE

Other

Enumeration date
08/02/2011
Last updated
08/02/2011
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