MEDICARE: ALIESHA ROCHELLE HANCOCK COMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255R0406X	Blind Rehabilitation Specialist/Technologist	22992

General Provider Information

NPI Number	:	1720785942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIESHA ROCHELLE HANCOCK COMS

Provider Business Mailing Address
First Line	:	3211 WRIGHTSBORO RD APT M12
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-4710
Country	:	US
Telephone Number	:	813-389-0829
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 FREEDOM WAY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30904-6258
Country	:	US
Telephone Number	:	706-733-0188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/08/2023

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