MEDICARE: RENEE HATCHER PT

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	1794	GA

General Provider Information

NPI Number	:	1710908827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE HATCHER PT

Provider Business Mailing Address
First Line	:	214 RIVER VALLEY TRL
Second Line	:
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2136
Country	:	US
Telephone Number	:	478-988-4024
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 S 3RD AVE
Second Line	:
City	:	MC RAE
State	:	GA
Zip	:	31055-1550
Country	:	US
Telephone Number	:	229-868-2174
Fax Number	:

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

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	07/08/2007

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Directions to “ RENEE HATCHER PT” Practice Location

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