MEDICARE: CHERYL ANN HANLY D.C.

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	111N00000X	Chiropractor	3380	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2458179A	OTHER	NC	MEDICARE PTAN

General Provider Information

NPI Number	:	1700852894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL ANN HANLY D.C.

Provider Business Mailing Address
First Line	:	106E WEST CHURCH ST
Second Line	:	PO BOX 786
City	:	CREEDMOOR
State	:	NC
Zip	:	27522
Country	:	US
Telephone Number	:	919-528-7290
Fax Number	:	919-528-7292

Provider Business Practice Location Address
First Line	:	106 W CHURCH ST STE E
Second Line	:
City	:	CREEDMOOR
State	:	NC
Zip	:	27522-9765
Country	:	US
Telephone Number	:	919-528-7290
Fax Number	:	919-528-7297

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	01/07/2009

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