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General NPI Number Information
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NPI Number | 1427938331
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Entity Type | Individual
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Provider Name | BRENT MATTHEW HATCH DPT
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Gender | Male
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 7849 TRAMWAY BLVD NE STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2529
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Country | US
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Telephone | 505-821-3831
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Fax |
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Provider Business Mailing Address
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Address Line | 7849 TRAMWAY BLVD NE STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2529
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-2025-0239
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License Number State | NM
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