Provider Demographics
NPI:1255327334
Name:HANSON, TODD ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ERIC
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:PO BOX 817
Mailing Address - Street 2:202 FRANKLIN ST
Mailing Address - City:MONONA
Mailing Address - State:IA
Mailing Address - Zip Code:52159-0817
Mailing Address - Country:US
Mailing Address - Phone:563-539-2996
Mailing Address - Fax:
Practice Address - Street 1:202 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:IA
Practice Address - Zip Code:52159-8219
Practice Address - Country:US
Practice Address - Phone:563-539-2996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA060092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0428391Medicaid
33291OtherWELLMARK
I6628Medicare ID - Type Unspecified
U90549Medicare UPIN