Provider Demographics
NPI:1295073476
Name:HATCH, JOHN DARRELL (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DARRELL
Last Name:HATCH
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 1:47 W 300 S
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-2020
Mailing Address - Country:US
Mailing Address - Phone:435-654-5888
Mailing Address - Fax:435-657-1444
Practice Address - Street 1:47 W 300 S
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-2020
Practice Address - Country:US
Practice Address - Phone:435-654-5888
Practice Address - Fax:435-657-1444
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT82446141202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor