Provider Demographics
NPI:1255480539
Name:HANSON, KRISTINA (DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 FOXCREST CT
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-6335
Mailing Address - Country:US
Mailing Address - Phone:801-891-5747
Mailing Address - Fax:
Practice Address - Street 1:4190 S HIGHLAND DR STE 202
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84124-2786
Practice Address - Country:US
Practice Address - Phone:801-891-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6251372-2401225100000X
UT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist