Provider Demographics
NPI:1962994467
Name:HANSEN, ANDREW LEO (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEO
Last Name:HANSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 W 340 N
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-9300
Mailing Address - Country:US
Mailing Address - Phone:801-850-7467
Mailing Address - Fax:
Practice Address - Street 1:1177 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84335-6764
Practice Address - Country:US
Practice Address - Phone:435-563-6887
Practice Address - Fax:435-535-0769
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7325686-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor