Individual
BLAIR HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
474 W 200 N, ST GEORGE, UT 84770-4505
(435) 634-5600
Mailing address
644 N 2240 E, ST GEORGE, UT 84790-1410
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6632621-3503
UT
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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