Individual
CONNOR HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
718 1ST AVE NW, NEW BRIGHTON, MN 55112-6809
(651) 315-5902
Mailing address
718 1ST AVE NW, NEW BRIGHTON, MN 55112-6809
(651) 315-5902
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
MN
225400000X
Rehabilitation Practitioner
—
MN
2255A2300X
Athletic Trainer
Primary
—
MN
227800000X
Certified Respiratory Therapist
—
MN
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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