Provider Demographics
NPI:1669293585
Name:BOOTH, HANNAH ELLEN
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:ELLEN
Last Name:BOOTH
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:HANNAH
Other - Middle Name:ELLEN
Other - Last Name:CORK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2795 BULVERDE RD
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-2195
Mailing Address - Country:US
Mailing Address - Phone:830-999-7668
Mailing Address - Fax:
Practice Address - Street 1:2795 BULVERDE RD
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-2195
Practice Address - Country:US
Practice Address - Phone:830-999-7668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor