Individual
DOROTHY JANE HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LMT
Contact information
Practice address
10939 QUEBEC AVE N, CHAMPLIN, MN 55316-3261
(320) 420-3723
Mailing address
10939 QUEBEC AVE N, CHAMPLIN, MN 55316-3261
(320) 420-3723
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
1839
MN
2083S0010X
Sports Medicine (Preventive Medicine) Physician
1839
MN
225700000X
Massage Therapist
—
MN
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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