Provider Demographics
NPI:1023416989
Name:HANNAN, MATTHEW (DPT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:HANNAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODRUFF INDUSTRIAL LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4101
Mailing Address - Country:US
Mailing Address - Phone:864-735-0593
Mailing Address - Fax:
Practice Address - Street 1:101 WOODRUFF INDUSTRIAL LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4101
Practice Address - Country:US
Practice Address - Phone:864-735-0593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0241262251X0800X
MD252872251X0800X
SC97272251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic