Individual
LANCE A HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
465 WASHINGTON ST, MONTPELIER, ID 83254-1544
(208) 847-4495
(208) 847-4336
Mailing address
465 WASHINGTON ST, MONTPELIER, ID 83254-1544
(208) 847-4495
(208) 847-4336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-11157
ID
Other
Enumeration date
06/24/2009
Last updated
12/05/2014
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