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NPI Code Detail

MEDICARE: DR. KIPLING GAYLE HANSEN D.C.

MEDICARE: DR. KIPLING GAYLE HANSEN D.C.
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
1111NS0005XSports Physician ChiropractorB-220NV

General Provider Information

NPI Number : 1407967532
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIPLING GAYLE HANSEN D.C.
Provider Business Mailing Address
First Line : 6212 W CHARLESTON BLVD
Second Line : SUITE 100
City : LAS VEGAS
State : NV
Zip : 89146-1163
Country : US
Telephone Number : 702-877-6767
Fax Number : 702-877-6434
Provider Business Practice Location Address
First Line : 6212 W CHARLESTON BLVD
Second Line : SUITE 100
City : LAS VEGAS
State : NV
Zip : 89146-1163
Country : US
Telephone Number : 702-877-6767
Fax Number : 702-877-6434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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