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General NPI Number Information
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NPI Number | 1699799213
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Entity Type | Individual
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Provider Name | SALLY HANNEMAN PT
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 104 GLEN OAK BLVD SUITE 180
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6423
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Country | US
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Telephone | 615-338-4391
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Fax | 615-338-4304
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Provider Business Mailing Address
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Address Line | 104 GLEN OAK BLVD SUITE 120
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6423
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Country | US
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Telephone | 615-338-4391
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Fax | 615-338-4304
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 1527
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License Number State | TN
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