Ivy A. Hansen, P.A.-C.
NPI #1164755104 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1164755104
- Entity Type
- Individual
- Name
- Ivy A. Hansen, P.A.-C.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- P.A.-C.
- Enumeration Date
- Sep 9, 2009
- Last Updated
- Sep 9, 2009
Practice Location
- Address
- 2065 E 17TH ST
- Address 2
- SUITE D
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-8042
- Phone
- (208) 522-0747
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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