Provider Demographics
NPI:1285152652
Name:HASSELL, PATRICK (ATC, CES)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:HASSELL
Suffix:
Gender:M
Credentials:ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-1450
Mailing Address - Country:US
Mailing Address - Phone:502-852-8093
Mailing Address - Fax:
Practice Address - Street 1:215 CENTRAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-1450
Practice Address - Country:US
Practice Address - Phone:502-852-8093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT7482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer