Provider Demographics
NPI:1003007600
Name:YANG, HANSON H (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:HANSON
Middle Name:H
Last Name:YANG
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 DUNEVILLE ST
Mailing Address - Street 2:APT 140
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1239
Mailing Address - Country:US
Mailing Address - Phone:832-640-3953
Mailing Address - Fax:
Practice Address - Street 1:5050 DUNEVILLE ST
Practice Address - Street 2:APT 140
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1239
Practice Address - Country:US
Practice Address - Phone:832-640-3953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0707028922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer