Healthcare Provider Details

I. General information

NPI: 1184530123
Provider Name (Legal Business Name): KATHERINE HANCOCK PT, DPT, CBIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 ALBANY TPKE STE 5
CANTON CT
06019-2557
US

IV. Provider business mailing address

76 RATLUM RD
BARKHAMSTED CT
06063-1814
US

V. Phone/Fax

Practice location:
  • Phone: 203-788-0009
  • Fax:
Mailing address:
  • Phone: 203-788-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: