Provider Demographics
NPI:1689637365
Name:HAHN, MARY C
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:HAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 OKEMOS ROAD,
Mailing Address - Street 2:SUITE # 8
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-2822
Mailing Address - Country:US
Mailing Address - Phone:517-349-7060
Mailing Address - Fax:
Practice Address - Street 1:4129 OKEMOS ROAD,
Practice Address - Street 2:SUITE # 8
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2822
Practice Address - Country:US
Practice Address - Phone:517-349-7060
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist