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KENNETH DAVID HANSEN O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1316159940

Individual Registrant:
 KENNETH DAVID HANSEN O.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
15936 E HIGHWAY 40  SILVER SPRINGS, FL 34488-5144 US
Tel: 352-625-0135  Fax: --

Contact information for business:
3705 SE 48TH ST  OCALA, FL 34480-7385 US
Tel: 352-622-3711  Fax: --

Registration Information:
NPI: 1316159940
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
FLOPC 1542

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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