Provider Demographics
NPI:1619166766
Name:HACKETT CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HACKETT CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-290-9097
Mailing Address - Street 1:6215 LEE HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2916
Mailing Address - Country:US
Mailing Address - Phone:423-305-1819
Mailing Address - Fax:423-305-1820
Practice Address - Street 1:6215 LEE HWY
Practice Address - Street 2:SUITE B
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2916
Practice Address - Country:US
Practice Address - Phone:423-305-1819
Practice Address - Fax:423-305-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty