Provider Demographics
NPI:1215971791
Name:HANSEN, MELEECE WINWARD (LAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:MELEECE
Middle Name:WINWARD
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 W UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2415
Mailing Address - Country:US
Mailing Address - Phone:435-586-7700
Mailing Address - Fax:
Practice Address - Street 1:351 W UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2470
Practice Address - Country:US
Practice Address - Phone:435-559-2104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer