Individual
THEODORE HANNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(445) 235-9507
Mailing address
5312 RIDGE AVE APT 404, PHILADELPHIA, PA 19128-3935
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MT225481
PA
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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