Hanson Group LLC

NPI #1295006039 in Rexburg, Idaho

Provider Information

NPI Number: 1295006039
Entity Type: Organization
Organization Name: Hanson Group LLC
Primary Specialty: Optometrist
Enumeration Date: Jan 25, 2012
Last Updated: Apr 25, 2012

Practice Location

Address: 24 E MAIN ST
City: Rexburg
State: Idaho
ZIP Code: 83440-1927
Phone: (208) 356-0881

Authorized Official

Name: DOUGLASS E HANSON, ODP
Title: OWNER
Phone: (208) 356-0881

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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