Individual
MR. JUSTIN JAMES HANNEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
15047 W 54TH DR, GOLDEN, CO 80403-2915
(720) 308-4567
Mailing address
3875 KALAKALA CIR S, SALEM, OR 97306-9709
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
1497
MA
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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