Provider Demographics
NPI:1033406137
Name:HANSEN, DANIEL JAY (DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAY
Last Name:HANSEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5232
Mailing Address - Country:US
Mailing Address - Phone:801-444-1227
Mailing Address - Fax:801-444-1228
Practice Address - Street 1:67 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5232
Practice Address - Country:US
Practice Address - Phone:801-444-1227
Practice Address - Fax:801-444-1228
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7937002-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist