Organization
HANSON PHYSICAL THERAPY & SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY HANSON DPT (OWNER)
(703) 407-4881
Entity
Organization
Contact information
Practice address
750 STATE ROUTE 3 S STE 5, GAMBRILLS, MD 21054-1306
(703) 407-4881
Mailing address
2505 REVERE CT, CROFTON, MD 21114-3253
(703) 407-4881
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BX02-0002
BCBS
MD
Enumeration date
07/03/2020
Last updated
07/03/2020
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