Provider Demographics
NPI:1326455734
Name:HAGER, CHRISTINE MARIE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:HAGER
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, SCAT
Mailing Address - Street 1:610 CLOVIS CT
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:SC
Mailing Address - Zip Code:29369-8840
Mailing Address - Country:US
Mailing Address - Phone:561-762-7179
Mailing Address - Fax:
Practice Address - Street 1:610 CLOVIS CT
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:SC
Practice Address - Zip Code:29369-8840
Practice Address - Country:US
Practice Address - Phone:561-762-7179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10612255A2300X
SCATH10242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer