Mac Jacob Hansen

NPI #1114640554 in Burnsville, Minnesota

Provider Information

NPI Number: 1114640554
Entity Type: Individual
Name: Mac Jacob Hansen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 21, 2022
Last Updated: Sep 21, 2022

Practice Location

Address: 1705 SOUTHCROSS DR W STE 101
City: Burnsville
State: Minnesota
ZIP Code: 55306-7012
Phone: (952) 225-1575

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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