Individual
MRS. KIMBERLY DENISE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
9501 OLD ANNAPOLIS RD, DORSEY HALL MEDICAL CENTER, SUITE 125, ELLICOTT CITY, MD 21042-6314
(410) 997-1063
(410) 997-1408
Mailing address
20410 CENTURY BLVD, SUITE 215, GERMANTOWN, MD 20874-1186
(301) 540-6140
(301) 540-5190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22921
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182132821
MEDICARE
MD
05
—
182132821
—
MD
Enumeration date
01/06/2010
Last updated
07/17/2014
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