Individual
SCOTT D. HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
16449 N. MIDLAND BLVD., NAMPA, ID 83687
(208) 467-7020
Mailing address
2121 S BEARTOOTH WAY, MERIDIAN, ID 83642-8126
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3562TX
WA
Other
Enumeration date
02/27/2007
Last updated
08/21/2009
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