Provider Demographics
NPI:1033229455
Name:SUZANNE B. HANSON DC A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:SUZANNE B. HANSON DC A CHIROPRACTIC CORPORATION
Other - Org Name:HANSON FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-924-6500
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-1848
Mailing Address - Country:US
Mailing Address - Phone:415-897-9195
Mailing Address - Fax:415-897-0346
Practice Address - Street 1:645 TAMALPAIS DR
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1613
Practice Address - Country:US
Practice Address - Phone:415-924-6500
Practice Address - Fax:415-897-0346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA900001537305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization