Individual
TYLER M HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Contact information
Practice address
370 E SOUTH TEMPLE, SUITE 250, SALT LAKE CITY, UT 84111-1206
(801) 512-2656
(801) 906-0336
Mailing address
370 E SOUTH TEMPLE, SUITE 250, SALT LAKE CITY, UT 84111-1206
(801) 512-2656
(801) 906-0336
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
360816-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5417
DMBA
UT
01
—
6400593
UNITED HEALTHCARE
UT
01
—
69157
PEHP
UT
01
—
870388269BR1
EDUCATORS MUTUAL
UT
01
—
CJ9402
RAILROAD MEDICARE
UT
01
—
QM0000061055
ALTIUS
UT
Enumeration date
08/03/2005
Last updated
10/12/2012
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