Provider Demographics
NPI:1972626588
Name:HATCH, SHARON A (DC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:HATCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SHELLBARK CT NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5110
Mailing Address - Country:US
Mailing Address - Phone:770-424-8192
Mailing Address - Fax:770-222-5883
Practice Address - Street 1:1899 LAKE RD
Practice Address - Street 2:SUITE 122
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2291
Practice Address - Country:US
Practice Address - Phone:770-222-5881
Practice Address - Fax:770-222-5883
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor