Provider Demographics
NPI:1487723623
Name:HANSON, JOAN E (PT)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:E
Last Name:HANSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27306 MEADOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-8233
Mailing Address - Country:US
Mailing Address - Phone:605-334-8616
Mailing Address - Fax:605-339-6982
Practice Address - Street 1:1721 S CLEVELAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-5501
Practice Address - Country:US
Practice Address - Phone:605-334-8616
Practice Address - Fax:605-339-6982
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6899Medicare ID - Type Unspecified