Provider Demographics
NPI:1992468334
Name:HANSON, ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 VENTURE DRIVE
Mailing Address - Street 2:DUBLIN
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43017
Mailing Address - Country:US
Mailing Address - Phone:614-355-8752
Mailing Address - Fax:
Practice Address - Street 1:5680 VENTURE DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2190
Practice Address - Country:US
Practice Address - Phone:614-355-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016841225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist