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Individual

MR. MARK PAUL HANAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.T.,C.

Contact information

Practice address
1131 CHAPEL CROSSING RD, FEDERAL LAW ENFORCEMENT TRAINING CENTER-BLDG. 252/PTD, BRUNSWICK, GA 31524-2002
(912) 280-5310
(912) 267-3708
Mailing address
111 CHAD CIR, BRUNSWICK, GA 31525-4695
(912) 399-4020

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
780481
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2255A2300X
ATHLETIC TRAINER
GA
Enumeration date
06/28/2006
Last updated
07/08/2007
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