Maren Hansen, ATC-L

Individual provider Active NPI Athletic Trainer · West Bountiful, UT

NPI 1851473383 · NPPES record last updated Jan 2, 2009

Key facts

NPI
1851473383
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1385197-4810 (UT)
Practice address
875 Summer Tree Dr
West Bountiful, UT 84087-1955
Phone
(801) 296-1139
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1385197-4810UTMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1385197-4810 UT Yes

Addresses

Primary practice location

875 Summer Tree Dr
West Bountiful, UT 84087-1955

Mailing address

875 Summer Tree Dr
West Bountiful, UT 84087-1955
Phone (801) 296-1139

Other providers in West Bountiful, UT

All providers in West Bountiful, UT · Athletic Trainer in Utah

Sources for this page

Verify at the official NPI Registry.