Provider Demographics
NPI:1013341411
Name:HANNAN, CHRISTOPHER BRENT (LMT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRENT
Last Name:HANNAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9364
Mailing Address - Country:US
Mailing Address - Phone:614-218-6007
Mailing Address - Fax:
Practice Address - Street 1:417 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1310
Practice Address - Country:US
Practice Address - Phone:614-218-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007725225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist