Provider Demographics
NPI:1760836787
Name:HASEKOESTER, ZACHERY LOUIS (ATC, MED)
Entity Type:Individual
Prefix:
First Name:ZACHERY
Middle Name:LOUIS
Last Name:HASEKOESTER
Suffix:
Gender:M
Credentials:ATC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:277 HIGHWAY 74 N STE 203
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1571
Practice Address - Country:US
Practice Address - Phone:678-364-0337
Practice Address - Fax:678-364-0858
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0023472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer