Individual
DR. KENNETH GORDON HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
218 E 800 S, OREM, UT 84058
(801) 225-2457
(801) 225-2537
Mailing address
218 E 800 S, OREM, UT 84058-5008
(801) 225-2457
(801) 225-2537
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1640901202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350002765
RAILROAD MEDICARE
—
Enumeration date
02/22/2006
Last updated
05/02/2012
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