Individual
RACQUEL LYN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
173 RB, PROVO, UT 84602-2000
(801) 422-1628
Mailing address
433 N 2750 W, PROVO, UT 84601-5111
(801) 822-6187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/05/2017
Last updated
07/05/2017
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