Provider Demographics
NPI:1437968922
Name:WILLFORD, HANNAH (DC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:WILLFORD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13600 COMMERCE BLVD APT 320
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4565
Mailing Address - Country:US
Mailing Address - Phone:218-766-0173
Mailing Address - Fax:
Practice Address - Street 1:7373 KIRKWOOD CT N STE 110
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5211
Practice Address - Country:US
Practice Address - Phone:763-898-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor