Provider Demographics
NPI:1871521534
Name:HANRAHAN, THOMAS M (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:HANRAHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 TRUMBULL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079-5339
Mailing Address - Country:US
Mailing Address - Phone:810-329-9121
Mailing Address - Fax:810-329-3914
Practice Address - Street 1:301 TRUMBULL ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079-5339
Practice Address - Country:US
Practice Address - Phone:810-329-9121
Practice Address - Fax:810-329-3914
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950G411210OtherBCBS
MITH005229OtherBCBS PIN
MIP30215FOtherBCN
MI1982117Medicaid
MI350031579OtherRAILROAD MEDICARE
MIT33567Medicare UPIN
MITH005229OtherBCBS PIN