Individual
MIKE WAYNE HANNEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS
Contact information
Practice address
2695 E KATELLA AVE, ANAHEIM, CA 92806-5904
(714) 940-2831
Mailing address
18701 FAIRWOOD LN, SANTA ANA, CA 92705-2161
(714) 743-9119
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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