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NPI Code Detail

MEDICARE: DR. NICOLAI LORENSON HANSEN DC

MEDICARE:  DR. NICOLAI LORENSON HANSEN  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor4278KY
2111N00000XChiropractorMC04424NJ

General Provider Information

NPI Number : 1508866617
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLAI LORENSON HANSEN DC
Provider Business Mailing Address
First Line : 5622 SOUTHLAND BLVD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40214-1211
Country : US
Telephone Number : 502-368-8568
Fax Number :
Provider Business Practice Location Address
First Line : 7439 3RD STREET RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40214-4366
Country : US
Telephone Number : 502-618-3060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 12/09/2010

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Directions to “ DR. NICOLAI LORENSON HANSEN DC” Practice Location

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