Organization
BRAD W HANNON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD W HANNON DC (DOCTOR/CEO)
(760) 949-0996
Entity
Organization
Contact information
Practice address
16808 MAIN ST STE B, HESPERIA, CA 92345-6033
(760) 949-0996
(760) 949-0777
Mailing address
16808 MAIN ST STE B, HESPERIA, CA 92345-6033
(760) 949-0996
(760) 949-0777
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710066675
NPI
—
Enumeration date
09/13/2010
Last updated
09/13/2010
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