Individual
MS. TAMMY LYNN HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
(606) 598-4506
(606) 598-1027
Mailing address
P.O. BOX 357, 134 JASMINE LANE, STINNET, KY 40868
(606) 598-4506
(606) 598-1027
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02401
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01004431
—
KY
Enumeration date
09/10/2009
Last updated
09/10/2009
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