Provider Demographics
NPI:1629846886
Name:HANKS, SHIAN N (LAT, ATC)
Entity type:Individual
Prefix:
First Name:SHIAN
Middle Name:N
Last Name:HANKS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 INVERNESS DR W STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5069
Mailing Address - Country:US
Mailing Address - Phone:719-377-0068
Mailing Address - Fax:
Practice Address - Street 1:175 INVERNESS DR W STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5069
Practice Address - Country:US
Practice Address - Phone:303-694-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSA.0003256246ZC0007X
MTATR-LAT-LIC-25482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant