Individual
GRANT HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18465 ORCHARD TRL STE 200, LAKEVILLE, MN 55044-2525
(651) 468-7689
Mailing address
561 S ELK ST, BELLE PLAINE, MN 56011-1507
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3792
MN
Other
Enumeration date
01/26/2023
Last updated
08/08/2024
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