Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 57531111205 | UT |
NPI | 1063445682 |
---|---|
Provider Name | Dr. Mette Hansen |
First Address | St George, UT 84790-4488 |
Second Address | St George, UT 84790-4488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 29/12/2021 |