Provider Demographics
NPI:1356767768
Name:HATCHEL, SAMUEL (DPT)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:HATCHEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1110
Mailing Address - Country:US
Mailing Address - Phone:919-791-6678
Mailing Address - Fax:
Practice Address - Street 1:620 SUMMIT CROSSING PL
Practice Address - Street 2:STE 305
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2176
Practice Address - Country:US
Practice Address - Phone:704-865-0077
Practice Address - Fax:704-852-3499
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist