Provider Demographics
NPI:1225145345
Name:HANSON, SUZAN JEAN (DC)
Entity Type:Individual
Prefix:
First Name:SUZAN
Middle Name:JEAN
Last Name:HANSON
Suffix:
Gender:F
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:PO BOX 1347
Mailing Address - Street 2:
Mailing Address - City:HETTINGER
Mailing Address - State:ND
Mailing Address - Zip Code:58639-1347
Mailing Address - Country:US
Mailing Address - Phone:701-567-2066
Mailing Address - Fax:
Practice Address - Street 1:117 S. MAIN
Practice Address - Street 2:
Practice Address - City:HETTINGER
Practice Address - State:ND
Practice Address - Zip Code:58639-1347
Practice Address - Country:US
Practice Address - Phone:701-567-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND466111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor