Individual
WALTER HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 N 200 W, EPHRAIM, UT 84627-1159
(435) 835-4316
(435) 835-4317
Mailing address
PO BOX 154, MANTI, UT 84642-0154
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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