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General NPI Number Information
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NPI Number | 1598219461
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Entity Type | Individual
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Provider Name | MEGAN MARCELLE HACKER ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 08/09/2016
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 1608 GUNBARREL RD STE 103
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7244
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Country | US
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Telephone | 423-892-8070
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Fax | 423-893-9891
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Provider Business Mailing Address
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Address Line | 6397 LEE HWY STE 300
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4915
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Country | US
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Telephone | 423-238-8930
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Fax | 423-254-5217
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT6817
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | BOC310111
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2625
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License Number State | TN
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