Individual
MR. DOUGLAS ALAN HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1112 E SULLY AVE, PIERRE, SD 57501-4104
(605) 786-3374
Mailing address
1112 E SULLY AVE, PIERRE, SD 57501-4104
(605) 786-3374
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0994
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5832770
—
SD
Enumeration date
03/29/2007
Last updated
05/26/2011
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