Individual
MR. MICHAEL J HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATR CSCS
Contact information
Practice address
1630 18TH AVE, WALL TOWNSHIP, NJ 07719-3744
(732) 556-2066
Mailing address
PO BOX 1199, WALL HIGH SCHOOL, WALL, NJ 07719
(732) 556-2066
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00011500
NJ
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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