Individual
JACK HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7679 E PHILLIPS CIR, CENTENNIAL, CO 80112-3250
(720) 245-3395
Mailing address
7679 E PHILLIPS CIR, CENTENNIAL, CO 80112-3250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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