Provider Demographics
NPI:1629378666
Name:HANRAHAN, CALVIN MACCLAREY
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:MACCLAREY
Last Name:HANRAHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5388 DISCOVERY PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8218
Mailing Address - Country:US
Mailing Address - Phone:757-707-3955
Mailing Address - Fax:757-603-6231
Practice Address - Street 1:5388 DISCOVERY PARK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8218
Practice Address - Country:US
Practice Address - Phone:757-903-4230
Practice Address - Fax:757-903-4231
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8223225100000X
VA2305213248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist