Provider Demographics
NPI:1053745018
Name:HANSEN, ERIK MICHAEL (PT)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:MICHAEL
Last Name:HANSEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13016 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1843
Mailing Address - Country:US
Mailing Address - Phone:913-226-9240
Mailing Address - Fax:
Practice Address - Street 1:13016 LINDEN ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-1843
Practice Address - Country:US
Practice Address - Phone:913-226-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060138225100000X
KS11-03527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist