Provider Demographics
NPI:1386942712
Name:HACKETT, PATRICK MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:HACKETT
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 1:1776 W JOHN BEERS RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-9409
Mailing Address - Country:US
Mailing Address - Phone:269-861-3144
Mailing Address - Fax:
Practice Address - Street 1:1776 W JOHN BEERS RD
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49127-9409
Practice Address - Country:US
Practice Address - Phone:248-505-9844
Practice Address - Fax:248-295-3787
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor