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Individual

DAIVD MICAH HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.EEG T.

Contact information

Practice address
9811 W CHARLESTON BLVD # 2-641, LAS VEGAS, NV 89117-7528
(855) 864-4322
(888) 315-4512
Mailing address
1000 S 800 E, OREM, UT 84097
(801) 921-3259

Taxonomy

Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
1884

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1884
R.EEG T.
Enumeration date
03/23/2015
Last updated
08/19/2015
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