Provider Demographics
NPI:1215325832
Name:HANNAN CHIROPRACTIC CENTER,INC
Entity type:Organization
Organization Name:HANNAN CHIROPRACTIC CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-914-1805
Mailing Address - Street 1:2028 E ROUTE 66
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4609
Mailing Address - Country:US
Mailing Address - Phone:626-914-1805
Mailing Address - Fax:626-914-1807
Practice Address - Street 1:2028 E ROUTE 66
Practice Address - Street 2:SUITE 202
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4609
Practice Address - Country:US
Practice Address - Phone:626-914-1805
Practice Address - Fax:626-914-1807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23268111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty