Provider Demographics
NPI:1346797727
Name:HANSEN, DALIN G (DPT)
Entity Type:Individual
Prefix:
First Name:DALIN
Middle Name:G
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 1:771 E 1300 N
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062
Mailing Address - Country:US
Mailing Address - Phone:385-985-7499
Mailing Address - Fax:385-225-9304
Practice Address - Street 1:305 S 850 E UNIT 101B
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043
Practice Address - Country:US
Practice Address - Phone:385-985-7499
Practice Address - Fax:385-225-9304
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10882220-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist