Provider Demographics
NPI: | 1366627846 |
---|---|
Name: | DON H HANSEN PHYSICAL THERAPY INC |
Entity Type: | Organization |
Organization Name: | DON H HANSEN PHYSICAL THERAPY INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DON |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | HANSEN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MPT |
Authorized Official - Phone: | 801-568-3873 |
Mailing Address - Street 1: | PO BOX 711185 |
Mailing Address - Street 2: | |
Mailing Address - City: | SALT LAKE CITY |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84171-1185 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 801-942-3311 |
Mailing Address - Fax: | 801-942-5955 |
Practice Address - Street 1: | 11333 S 1000 E |
Practice Address - Street 2: | STE 101 |
Practice Address - City: | SANDY |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84094-5429 |
Practice Address - Country: | US |
Practice Address - Phone: | 801-571-3318 |
Practice Address - Fax: | 801-571-3319 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-01-03 |
Last Update Date: | 2008-01-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |