Individual
MR. JOSEPH HACKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, MED, CSCS
Contact information
Practice address
1918 DECLARATION DR, INDEPENDENCE, KY 41051-7931
(859) 356-0179
Mailing address
1918 DECLARATION DR, INDEPENDENCE, KY 41051-7931
(859) 356-0179
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT803
KY
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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