Individual
CHASE WILLIAM HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2210 CORONADO ST, IDAHO FALLS, ID 83404-7430
(208) 522-3355
(208) 522-6019
Mailing address
2210 CORONADO ST, IDAHO FALLS, ID 83404-7430
(208) 522-3355
(208) 522-6019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PENDING
MN
Other
Enumeration date
09/06/2019
Last updated
08/31/2021
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