Individual
RANDI HANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 WHITNEY RANCH DR STE B6, HENDERSON, NV 89014-2643
(702) 454-1162
Mailing address
1847 HEYDON CT, HENDERSON, NV 89014-3868
(702) 454-1837
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0224
LICENSE#
NV
Enumeration date
11/02/2006
Last updated
07/08/2007
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