Provider Demographics
NPI:1700852894
Name:HANLY, CHERYL ANN (DC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:HANLY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106E WEST CHURCH ST
Mailing Address - Street 2:PO BOX 786
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522
Mailing Address - Country:US
Mailing Address - Phone:919-528-7290
Mailing Address - Fax:919-528-7292
Practice Address - Street 1:106 W CHURCH ST STE E
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-9765
Practice Address - Country:US
Practice Address - Phone:919-528-7290
Practice Address - Fax:919-528-7297
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2458179AOtherMEDICARE PTAN