Individual
TIMOTHY EMIL HANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
150 BOBBY DODD WAY NW, ATLANTA, GA 30332-0001
(404) 894-2529
Mailing address
1109 PLEASANT OAKS CT, LAWRENCEVILLE, GA 30044-7603
(404) 894-2529
(404) 894-0695
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000734
GA
Other
Enumeration date
03/31/2006
Last updated
07/08/2007
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