Individual
CARL HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1516 E TROPICANA AVE STE 130, LAS VEGAS, NV 89119-6552
(702) 909-8442
Mailing address
1516 E TROPICANA AVE STE 130, LAS VEGAS, NV 89119-6552
(702) 909-8442
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
12/26/2017
Last updated
12/26/2017
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