Provider Demographics
NPI:1508297748
Name:HANNEGAN, ELIZABETH CARRIE (DPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CARRIE
Last Name:HANNEGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 LOUCKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-7902
Mailing Address - Country:US
Mailing Address - Phone:717-764-0144
Mailing Address - Fax:717-764-0554
Practice Address - Street 1:1805 LOUCKS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-7902
Practice Address - Country:US
Practice Address - Phone:717-764-0144
Practice Address - Fax:717-764-0554
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist