Doctor Name: | KELLI HANSEN |
NPI Number: | 1447659545 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 4894 |
Business Practice Address: | 221 Highway 53 Suite D Cook, MN - 557235102 |
Business Phone Number: | 2186662697 |
Business Fax Number: | |
Mailing Address: | 8757 Johnson Rd, ANGORA |
State: | MN |
Postal Code: | 557038141 |
Phone Number: | 2187507654 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2014 |
NPI Last Update Date: | 08/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4894 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |