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Individual

SAMANTHA HACHERL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
4400 UNIVERSITY DR, FAIRFAX, VA 22030-4422
(703) 993-1000
Mailing address
9824 UPPER MILL LOOP, BRISTOW, VA 20136-2410

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1111
N/A
Enumeration date
05/20/2016
Last updated
03/01/2018
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