Provider Demographics
NPI:1588720353
Name:HANSEN, STEVEN JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JOSEPH
Last Name:HANSEN
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 1:402 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-9704
Mailing Address - Country:US
Mailing Address - Phone:717-786-1412
Mailing Address - Fax:
Practice Address - Street 1:402 BUCK RD
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-9704
Practice Address - Country:US
Practice Address - Phone:717-786-1412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005005L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01476865 01Medicaid
PA01476865 01Medicaid
PA129191Medicare PIN