Provider Demographics
NPI:1871757310
Name:HANSEN, CHRISTOPHER LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LYNN
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 1:3364 BROOKSONG WAY
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1199
Mailing Address - Country:US
Mailing Address - Phone:770-597-6907
Mailing Address - Fax:
Practice Address - Street 1:3421 RIDGE RD
Practice Address - Street 2:SUITE A-101
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7222
Practice Address - Country:US
Practice Address - Phone:770-597-6907
Practice Address - Fax:770-597-6907
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor