Provider Demographics
NPI:1497040851
Name:HANNEGAN, STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:HANNEGAN
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 1:419 LICKING PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:WILDER
Mailing Address - State:KY
Mailing Address - Zip Code:41071-3046
Mailing Address - Country:US
Mailing Address - Phone:859-360-0664
Mailing Address - Fax:859-360-3143
Practice Address - Street 1:419 LICKING PIKE STE B
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:KY
Practice Address - Zip Code:41071-3046
Practice Address - Country:US
Practice Address - Phone:859-360-0664
Practice Address - Fax:859-360-3143
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor