Individual
CAROLYN E HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S COURT ST, MANCHESTER, KY 40962-1295
(606) 598-2425
(606) 598-4448
Mailing address
PO BOX 158, MANCHESTER, KY 40962-0158
(606) 598-5564
(606) 598-6615
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
05-1875
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-1875
R.D.
KY
Enumeration date
02/15/2007
Last updated
07/08/2007
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