Individual
MRS. CAROLYN MARY HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1112 S. STEPHENSON AVE., IRON MOUNTAIN, MI 49801-0189
(906) 774-3654
(906) 774-5502
Mailing address
P.O. BOX 189, IRON MOUNTAIN, MI 49801-0189
(906) 774-3654
(906) 774-5502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302411095
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302411095
BOARD OF PHARMACY
MI
Enumeration date
07/17/2008
Last updated
09/25/2009
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