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Individual

JACOB HYDE HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
4625 TRAIL BOSS DR, CASTLE ROCK, CO 80104-2803
(925) 449-3356
(925) 449-5229
Mailing address
4625 TRAIL BOSS DR, CASTLE ROCK, CO 80104-2803
(720) 893-2225

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHR0007032
CO
111N00000X
Chiropractor
DC31942
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
821009639
WAITING FOR MEDICARE NUMBER TO COME THROUGH
Enumeration date
03/14/2011
Last updated
07/21/2022
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