Provider Demographics
NPI:1669453874
Name:HANNAN, DANIEL J (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:HANNAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 HUBBELL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-3067
Mailing Address - Country:US
Mailing Address - Phone:515-263-1313
Mailing Address - Fax:515-262-9239
Practice Address - Street 1:2821 HUBBELL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317-3067
Practice Address - Country:US
Practice Address - Phone:515-263-1313
Practice Address - Fax:515-262-9239
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0191023Medicaid
IA19102Medicare PIN
IAT01101Medicare UPIN
IA$$$$$$$$$Medicare PIN