Individual
DR. SUSAN ELIZABETH HANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HSD
Contact information
Practice address
1 MORROW WAY, SLIPPERY ROCK UNIVERSITY, SLIPPERY ROCK, PA 16057-1313
(724) 738-2794
(724) 738-2881
Mailing address
232 E WATER ST, SLIPPERY ROCK, PA 16057-1151
(724) 794-3931
(724) 738-2881
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000441A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PROVIDER CODE 22
PROVIDER CODE 22
PA
Enumeration date
11/01/2006
Last updated
07/08/2007
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