Provider Demographics
NPI:1265598627
Name:HANSON, LAURA ANNE (DC, MS,DICCP, NDT)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE
Last Name:HANSON
Suffix:
Gender:F
Credentials:DC, MS,DICCP, NDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4930 LONG ISLAND TER
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2572
Mailing Address - Country:US
Mailing Address - Phone:678-501-5172
Mailing Address - Fax:
Practice Address - Street 1:4930 LONG ISLAND TER
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2572
Practice Address - Country:US
Practice Address - Phone:678-501-5172
Practice Address - Fax:650-265-1762
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005530111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology