Individual
MR. MICHAEL EDWARD HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
7733 FORSYTH BLVD, SAINT LOUIS, MO 63105-1817
(800) 677-1238
Mailing address
28 MELWOOD DR, BELLEVILLE, IL 62223-2905
(618) 670-6239
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
120019
MO
171W00000X
Contractor
Primary
160.002570
IL
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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