Provider Demographics
NPI:1780809731
Name:HANSON, INC.
Entity type:Organization
Organization Name:HANSON, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:C
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:814-634-0664
Mailing Address - Street 1:103 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MEYERSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15552-1320
Mailing Address - Country:US
Mailing Address - Phone:814-634-0664
Mailing Address - Fax:814-634-5506
Practice Address - Street 1:103 CENTER ST
Practice Address - Street 2:
Practice Address - City:MEYERSDALE
Practice Address - State:PA
Practice Address - Zip Code:15552-1320
Practice Address - Country:US
Practice Address - Phone:814-634-0664
Practice Address - Fax:814-634-5506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006543L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007688770004Medicaid
PA1007688770004Medicaid
PAU61426Medicare UPIN
PA188081Medicare ID - Type UnspecifiedMEDICARE NUMBER