Provider Demographics
NPI:1205836210
Name:HATCH, FRANK VERNON (PT)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:VERNON
Last Name:HATCH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1850 OLD PECOS TRL STE H
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4760
Mailing Address - Country:US
Mailing Address - Phone:505-983-2673
Mailing Address - Fax:505-832-3321
Practice Address - Street 1:1850 OLD PECOS TRL STE H
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4760
Practice Address - Country:US
Practice Address - Phone:505-983-2673
Practice Address - Fax:505-832-3321
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1833OtherSTATE OF NM REG. & LIC.