Provider Demographics
NPI:1063686806
Name:HANSON, MICHAEL SVEND (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SVEND
Last Name:HANSON
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 1:5612 W MANDY CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2897
Mailing Address - Country:US
Mailing Address - Phone:320-310-4000
Mailing Address - Fax:320-253-1575
Practice Address - Street 1:5023 S BUR OAK PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2228
Practice Address - Country:US
Practice Address - Phone:605-250-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1063686806OtherDHS