Provider Demographics
NPI:1639491012
Name:HANSON, ERIK WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:WILLIAM
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 1:2220 GRANDVIEW DR STE 110
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1661
Mailing Address - Country:US
Mailing Address - Phone:859-320-0245
Mailing Address - Fax:859-320-1815
Practice Address - Street 1:2220 GRANDVIEW DR STE 110
Practice Address - Street 2:
Practice Address - City:FORT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-1661
Practice Address - Country:US
Practice Address - Phone:859-320-0245
Practice Address - Fax:859-320-1815
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY274260111N00000X
IN08002061A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN08002061AOtherINDIANA STATE LICENSE NUMBER