Healthcare Provider Details

I. General information

NPI: 1033406137
Provider Name (Legal Business Name): DANIEL JAY HANSEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6069 HIGHLAND DR
HOLLADAY UT
84121
US

IV. Provider business mailing address

6069 HIGHLAND DR
HOLLADAY UT
84121
US

V. Phone/Fax

Practice location:
  • Phone: 801-944-1209
  • Fax: 801-274-1180
Mailing address:
  • Phone: 801-944-1209
  • Fax: 801-274-1180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7937002-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: