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Individual

MR. DAVID MATTHEW HANAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
6050 ROUTE US 20, LAFAYETTE, NY 13084
(585) 247-6930
Mailing address
101 GRIFFIN DR, FAYETTEVILLE, NY 13066-1923
(585) 247-6930

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
007685
NY
225700000X
Massage Therapist
0076851
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
127397GG
PREFERRED CARE
NY
01
615879500
U.S. DEPARTMENT OF LABOR OFFICE OF WORKERS COMPENSATION PROGRAM (OWCP)
Enumeration date
03/22/2007
Last updated
10/02/2019
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