Individual
PHILLIP V HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
876 W 700 S, SALT LAKE CITY, UT 84104-1404
(801) 867-4715
Mailing address
876 W 700 S, SALT LAKE CITY, UT 84104-1404
(801) 867-4715
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
108137-4002
UT
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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