Provider Demographics
NPI:1851758130
Name:HANEL, JOSEPH (LAT/ ATC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:HANEL
Suffix:
Gender:M
Credentials:LAT/ ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N1818 SWANEE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8803
Mailing Address - Country:US
Mailing Address - Phone:920-809-7886
Mailing Address - Fax:
Practice Address - Street 1:101 W EDISON AVE
Practice Address - Street 2:110
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1367
Practice Address - Country:US
Practice Address - Phone:920-209-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer