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1720452709
DONALD HANSEN
BOLINGBROOK, IL
NPI
1720452709
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
291U00000X Clinical Medical Laboratory
(Licence: IL 14D2099042)
Enumeration Date
2015-11-13
Last Update Date
2015-11-13
Business Address
-- DONALD HANSEN OWNER
541 SPRUCE RD
BOLINGBROOK, IL 60440-2504
Phone number: 630-750-7378
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Mailing Address
-- DONALD HANSEN OWNER
541 SPRUCE RD
BOLINGBROOK, IL 60440-2504
Phone number: 630-750-7378
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