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Individual

CAROLINE HACKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
15 SPORTS MEDICINE DRIVE, SUITE 101, FISHERSVILLE, VA 22939
(540) 213-2537
(540) 213-2522
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 932-4708
(540) 932-5642

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180330
SOUTHERN HEALTH
VA
01
710000427
PALMETTO
VA
Enumeration date
02/23/2006
Last updated
11/13/2023
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