NPI 1255894804

Jacob Hansen, OD

Practitioner Optometrist Spanish Fork, UT

Practice location

Address: 1295 N Canyon Creek Pkwy, Spanish Fork, UT 84660-1319
Phone: (801) 504-9645

Registered specialties (2)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 9432999-9934 (UT)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1255894804
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Apr 2019
Record last updated: 23 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.