Hackley, Shawn Rueze

Hackley, Shawn Rueze is an individual health care provider with primary practice located at 501 Cypress St , Fort Bragg CA 95437-5429. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Hackley, Shawn Rueze can be contacted via phone (707) 961-6191.

Contact Information

Primary practice address
501 Cypress St Fort Bragg CA 95437-5429
Phone: (707) 961-6191
Fax: (707) 964-6213
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT14615 California

Profile Details

NPI number 1295923233
LBN Legal business name Hackley, Shawn Rueze
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2007
Last updated Dec 28th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295923233 NPPES
Other 1235316993 CORPORATION NPI

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