Provider Demographics
NPI:1255162749
Name:HANKS, HUNTER (DPT)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:HANKS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 N GATEWAY DR UNIT 423
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9852
Mailing Address - Country:US
Mailing Address - Phone:801-866-3705
Mailing Address - Fax:
Practice Address - Street 1:169 N GATEWAY DR STE 160
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9882
Practice Address - Country:US
Practice Address - Phone:435-799-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13972005-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist