Provider Demographics
NPI:1487173563
Name:BETTER SPINE HEALTH 360
Entity type:Organization
Organization Name:BETTER SPINE HEALTH 360
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:WELLS
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-670-4971
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:ISANTI
Mailing Address - State:MN
Mailing Address - Zip Code:55040-0430
Mailing Address - Country:US
Mailing Address - Phone:612-670-4971
Mailing Address - Fax:
Practice Address - Street 1:2780 SNELLING AVE N STE 310
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-7125
Practice Address - Country:US
Practice Address - Phone:612-670-4971
Practice Address - Fax:612-440-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty