Individual
TARA HACKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3720 QUEEN CT SW STE I, CEDAR RAPIDS, IA 52404-4735
(319) 364-0300
(319) 364-4043
Mailing address
625 ENTERPRISE DR., OAK BROOK, IL 60523-8813
(630) 575-6250
(630) 575-7450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-020547
IL
225100000X
Physical Therapist
Primary
088267
IA
Other
Enumeration date
04/08/2014
Last updated
03/17/2018
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