MEDICARE: LAURIE HANNA

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	225100000X	Physical Therapist	1130656	TX

General Provider Information

NPI Number	:	1891152971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE HANNA

Provider Business Mailing Address
First Line	:	107 N MEDINA ST
Second Line	:
City	:	LOCKHART
State	:	TX
Zip	:	78644-1919
Country	:	US
Telephone Number	:	512-398-5213
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 N MEDINA ST
Second Line	:
City	:	LOCKHART
State	:	TX
Zip	:	78644-1919
Country	:	US
Telephone Number	:	512-398-5213
Fax Number	:

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

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	01/20/2016

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Directions to “ LAURIE HANNA ” Practice Location

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