Provider Demographics
NPI:1215594528
Name:HANSON, DANIEL (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
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:PO BOX 10114
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28404-0114
Mailing Address - Country:US
Mailing Address - Phone:910-686-5433
Mailing Address - Fax:910-686-6737
Practice Address - Street 1:7649 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9458
Practice Address - Country:US
Practice Address - Phone:910-686-5433
Practice Address - Fax:910-686-6737
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor