Individual
DAWN MARIE HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1519 60TH STREET, KENOSHA, WI 53140-3954
(262) 656-7500
(262) 656-7500
Mailing address
6018 8TH AVENUE APT.1, KENOSHA, WI 53143
(262) 412-8265
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1785-019
WI
Other
Enumeration date
02/07/2012
Last updated
11/17/2015
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