Individual
MRS. LORRAINE SUE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
20402 N 15TH AVE, PHOENIX, AZ 85027-3636
(623) 376-3975
Mailing address
7922 W BEAUBIEN DR, PEORIA, AZ 85382-5419
(623) 256-2568
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2328
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
455627
—
AZ
Enumeration date
04/02/2007
Last updated
07/09/2007
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