Individual
SPENCER KIMBALL HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
324 E 10TH AVE STE 178, SLC, UT 84103
(801) 408-8500
Mailing address
PO BOX 27128, SLC, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10801683-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2012
Last updated
08/21/2018
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