Provider Demographics
NPI:1598038465
Name:HANN, JONATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:HANN
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 1:7758 WALLACE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7219
Mailing Address - Country:US
Mailing Address - Phone:407-851-9114
Mailing Address - Fax:497-851-9115
Practice Address - Street 1:7758 WALLACE RD
Practice Address - Street 2:SUITE F
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7219
Practice Address - Country:US
Practice Address - Phone:407-851-9114
Practice Address - Fax:497-851-9115
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor