Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1821318072 |
---|---|
Provider Name | Mr. Abraham R Hancock |
First Address | Utica, MS 39175-9731 |
Second Address | Chillicothe, OH 45601-9718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2010 |
Last Update Date | 09/06/2010 |