Provider Demographics
NPI:1194802942
Name:HATRAK, MICHAEL FREDRICK (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FREDRICK
Last Name:HATRAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6495 SHILOH RD
Mailing Address - Street 2:SUITE A2-110
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-1635
Mailing Address - Country:US
Mailing Address - Phone:770-740-9200
Mailing Address - Fax:770-752-5607
Practice Address - Street 1:6495 SHILOH RD
Practice Address - Street 2:SUITE A2-110
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-1635
Practice Address - Country:US
Practice Address - Phone:770-740-9200
Practice Address - Fax:770-752-5607
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO002950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor