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Individual

PHILLIP HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
36 HAWTHORNE ST, APT 10, MEDFORD, OR 97504-7114
(541) 776-2333
(541) 776-2495
Mailing address
36 HAWTHORNE ST, APT 10, MEDFORD, OR 97504-7114
(541) 776-2333
(541) 776-2495

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13018-24
WI
225100000X
Physical Therapist
1994
ND
225100000X
Physical Therapist
Primary
61496
OR

Other

Enumeration date
06/03/2015
Last updated
12/13/2016
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