MEDICARE: ERIC S 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
1	111N00000X	Chiropractor	10125	FL

General Provider Information

NPI Number	:	1801113691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC S HANSEN DC

Provider Business Mailing Address
First Line	:	3020 E COMMERCIAL BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4312
Country	:	US
Telephone Number	:	954-351-5565
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 E COMMERCIAL BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4312
Country	:	US
Telephone Number	:	954-351-5565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2010
Last Update Date	:	02/09/2012

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Directions to “ ERIC S HANSEN DC” Practice Location

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