Basic Information
| Provider Information | |||||||||
| NPI: | 1932352598 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANSON | ||||||||
| FirstName: | EMELIAH | ||||||||
| MiddleName: | CONSTANCE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3130 E BASELINE RD | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852047290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803451980 | ||||||||
| FaxNumber: | 4809261721 | ||||||||
| Practice Location | |||||||||
| Address1: | 3130 E BASELINE RD | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852047290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803451980 | ||||||||
| FaxNumber: | 4809261721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2008 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 7944 | AZ | Y | Chiropractic Providers | Chiropractor |
No ID Information.