Organization
HANSON CLINIC PC
Active
Other names
Hanson Clinic MRI
Organization subpart
No
Provider details
NPI number
Authorized official
ANNIE M WALTER (CREDENTIALING MANAGER)
(719) 766-9004
Entity
Organization
Contact information
Practice address
109 S BURLINGTON DR, PUEBLO WEST, CO 81007-5560
(719) 766-9000
(719) 766-9010
Mailing address
109 S BURLINGTON DR, PUEBLO WEST, CO 81007-5560
(719) 766-9000
(719) 766-9010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17496
CO
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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