Individual
MRS. MARY CATHERINE HACKENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
76 MALLARD CT, TRENTON, SC 29847-3440
(803) 643-1869
(803) 643-1869
Mailing address
76 MALLARD CT, TRENTON, SC 29847-3440
(803) 643-1869
(803) 643-1869
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3237
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1168
—
SC
Enumeration date
01/22/2007
Last updated
07/08/2007
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