Provider Demographics
NPI:1184034340
Name:HATCHER, TRACEY (ATC/LAT)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:HATCHER
Suffix:
Gender:M
Credentials:ATC/LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 SW 6TH AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1004
Mailing Address - Country:US
Mailing Address - Phone:785-232-9805
Mailing Address - Fax:785-232-9806
Practice Address - Street 1:6001 SW 6TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1004
Practice Address - Country:US
Practice Address - Phone:785-232-9805
Practice Address - Fax:785-232-9806
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24000472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer