Provider Demographics
NPI:1710125273
Name:HACKETT, JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:HACKETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 RINGWOOD MDWS
Mailing Address - Street 2:BLDG A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-2033
Mailing Address - Country:US
Mailing Address - Phone:941-704-6396
Mailing Address - Fax:
Practice Address - Street 1:4921 RINGWOOD MDWS
Practice Address - Street 2:BLDG A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-2033
Practice Address - Country:US
Practice Address - Phone:941-704-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor