Individual
DR. SAMUEL JON HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
123 E MEDICAL LN, WEST COLUMBIA, SC 29169-4813
(803) 791-2397
(803) 936-8184
Mailing address
123 E MEDICAL LN, WEST COLUMBIA, SC 29169-4813
(803) 791-2397
(803) 936-8184
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12290
SC
225100000X
Physical Therapist
6218
OR
2251X0800X
Orthopedic Physical Therapist
PT-2773
ID
Other
Enumeration date
06/03/2010
Last updated
08/27/2024
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