Provider Demographics
NPI:1366116428
Name:HACK, PARKER (DC)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:
Last Name:HACK
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 1:30 MARBLE ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733-1120
Mailing Address - Country:US
Mailing Address - Phone:802-247-6464
Mailing Address - Fax:
Practice Address - Street 1:30 MARBLE ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:VT
Practice Address - Zip Code:05733-1120
Practice Address - Country:US
Practice Address - Phone:802-247-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006.0134162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor