Healthcare Provider Details

I. General information

NPI: 1477071686
Provider Name (Legal Business Name): DAVID TODD HAKANSON SR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 W SOJO DR # 210-06
SOUTH JORDAN UT
84095-1212
US

IV. Provider business mailing address

10459 S SAGE VISTA WAY
SOUTH JORDAN UT
84009-3955
US

V. Phone/Fax

Practice location:
  • Phone: 636-432-8771
  • Fax:
Mailing address:
  • Phone: 636-432-8771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10768566-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: