Provider Demographics
NPI:1952296444
Name:HANSON, AVERY (DPT)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 COMMONS DR W UNIT 3105
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-8652
Mailing Address - Country:US
Mailing Address - Phone:850-621-2018
Mailing Address - Fax:
Practice Address - Street 1:200 CALUSA BLVD UNIT 300
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5806
Practice Address - Country:US
Practice Address - Phone:850-460-2024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist