Provider Demographics
NPI:1497886246
Name:HANSEN, KEITH STERLING (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:STERLING
Last Name:HANSEN
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 1:891 E 9400 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3671
Mailing Address - Country:US
Mailing Address - Phone:801-569-8181
Mailing Address - Fax:801-569-8191
Practice Address - Street 1:891 E 9400 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3671
Practice Address - Country:US
Practice Address - Phone:801-569-8181
Practice Address - Fax:801-569-8191
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176283-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor