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1962989640
JILLIAN ANN HACKER
FORT WAYNE, IN
NPI
1962989640
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36003377A)
Enumeration Date
2018-07-25
Last Update Date
2020-09-03
Business Address
JILLIAN ANN HACKER ATC
3946 ICE WAY
FORT WAYNE, IN 46805-1018
Phone number: 260-444-2788
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Mailing Address
JILLIAN ANN HACKER ATC
8813 GULF DR APT B
FORT WAYNE, IN 46825-3092
Phone number: 765-524-7455
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