Individual
JACOB HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 KASOTA AVE SE STE A, MINNEAPOLIS, MN 55414-2842
(612) 672-5347
Mailing address
711 KASOTA AVE SE STE A, MINNEAPOLIS, MN 55414-2842
(612) 672-5347
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
122897
MN
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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