Provider Demographics
NPI:1568799773
Name:HACKETT, ERIKA J (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:J
Last Name:HACKETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5471 DR MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-4265
Mailing Address - Country:US
Mailing Address - Phone:314-367-5820
Mailing Address - Fax:314-367-7010
Practice Address - Street 1:2275 W MAGEE RD
Practice Address - Street 2:#112
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-4309
Practice Address - Country:US
Practice Address - Phone:520-498-0082
Practice Address - Fax:520-498-0085
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8349111N00000X
NYX011694111N00000X
MO2015038600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ163420Medicare UPIN
NYJ400031577Medicare UPIN