Individual
TIMOTHY HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCS
Contact information
Practice address
413 SIPAPU ST, BOX 6952, TAOS, NM 87571-6489
(575) 758-5857
(575) 758-5860
Mailing address
413 SIPAPU ST, BOX 6952, TAOS, NM 87571-6489
(575) 758-5857
(575) 758-5860
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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