Provider Demographics
NPI:1568609329
Name:HASSLER, JEREMY LEE (ATC)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:LEE
Last Name:HASSLER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 S ATHLETES PL
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-8519
Mailing Address - Country:US
Mailing Address - Phone:480-449-9000
Mailing Address - Fax:480-449-9200
Practice Address - Street 1:650 S ATHLETES PL
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-8519
Practice Address - Country:US
Practice Address - Phone:480-449-9000
Practice Address - Fax:480-449-9200
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer