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General NPI Number Information
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NPI Number | 1033229455
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Entity Type | Organization
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Legal Business Name | SUZANNE B. HANSON DC A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 645 TAMALPAIS DR
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City | CORTE MADERA
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State | CA
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Zip | 94925-1613
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Country | US
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Telephone | 415-924-6500
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Fax | 415-897-0346
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Provider Business Mailing Address
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Address Line | PO BOX 1848
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City | NOVATO
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State | CA
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Zip | 94948-1848
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Country | US
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Telephone | 415-897-9195
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Fax | 415-897-0346
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | MRS. SUZANNE B. HANSON
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Credential | D.C.
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Telephone | 415-924-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 900001537
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License Number State | CA
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