MEDICARE: ANNA HANUS CA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist		AZ

General Provider Information

NPI Number	:	1649057381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA HANUS CA

Provider Business Mailing Address
First Line	:	1801 PONY SOLDIER RD
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86303-5068
Country	:	US
Telephone Number	:	928-925-3970
Fax Number	:

Provider Business Practice Location Address
First Line	:	6546 E 2ND ST STE C
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-3540
Country	:	US
Telephone Number	:	928-772-4044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2023
Last Update Date	:	09/14/2023

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Directions to “ ANNA HANUS CA” Practice Location

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