Provider Demographics
NPI:1194890582
Name:HANSON, DANA DALE (DC)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:DALE
Last Name:HANSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3970 TAMPA ROAD
Mailing Address - Street 2:SUITE # D
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3210
Mailing Address - Country:US
Mailing Address - Phone:813-749-8940
Mailing Address - Fax:813-749-8944
Practice Address - Street 1:3970 TAMPA RD
Practice Address - Street 2:SUITE # D
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3210
Practice Address - Country:US
Practice Address - Phone:813-749-8940
Practice Address - Fax:813-749-8944
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor