Provider Demographics
NPI:1134350960
Name:HANSEN, DANIEL ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:HANSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 E 3900 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2151
Mailing Address - Country:US
Mailing Address - Phone:801-233-0033
Mailing Address - Fax:
Practice Address - Street 1:8541 REDWOOD RD # D
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9327
Practice Address - Country:US
Practice Address - Phone:801-233-0033
Practice Address - Fax:801-233-0088
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT74040491202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor