Provider Demographics
NPI:1841415734
Name:HANSON, RYAN MARK (AUD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MARK
Last Name:HANSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 W HOSPITAL DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4214
Mailing Address - Country:US
Mailing Address - Phone:435-637-4327
Mailing Address - Fax:435-613-9709
Practice Address - Street 1:945 W HOSPITAL DR
Practice Address - Street 2:SUITE #1
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4214
Practice Address - Country:US
Practice Address - Phone:435-637-4327
Practice Address - Fax:435-613-9709
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6265845-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist