Individual
CHRISTOPHER W HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 499-5191
Mailing address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 499-5191
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501016358
MI
225100000X
Physical Therapist
9916-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40374500
—
WI
01
—
5501016358
PROFESSIONAL LICENSE
MI
01
—
9916-024
STATE LICENSE NUMBER
WI
Enumeration date
08/04/2008
Last updated
04/30/2019
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