Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1092732 | TX |
NPI | 1083819346 |
---|---|
Provider Name | Rhonda Joleen Hansen |
First Address | Henrietta, TX 76365-2037 |
Second Address | Jacksboro, TX 76458-1848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 08/07/2007 |