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NPI Code Detail

MEDICARE: MRS. PATRICIA HACKER PTA

MEDICARE: MRS. PATRICIA HACKER PTA
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
1225100000XPhysical TherapistA00914KY

General Provider Information

NPI Number : 1063506988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA HACKER PTA
Provider Business Mailing Address
First Line : 20 HACKER FARM RD
Second Line :
City : MANCHESTER
State : KY
Zip : 40962
Country : US
Telephone Number : 606-598-7446
Fax Number :
Provider Business Practice Location Address
First Line : 376 MANCHESTER SQUARE
Second Line :
City : MANCHESTER
State : KY
Zip : 40962-9998
Country : US
Telephone Number : 606-598-7673
Fax Number : 606-598-7948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. PATRICIA HACKER PTA” Practice Location

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