Healthcare Provider Details

I. General information

NPI: 1013970706
Provider Name (Legal Business Name): DAWN M. HANKINS PHD, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 COLLEGE RD MCKENDREE COLLEGE
LEBANON IL
62254-1291
US

IV. Provider business mailing address

165 RUTHERGLEN
VALLEY PARK MO
63088-1552
US

V. Phone/Fax

Practice location:
  • Phone: 618-537-6917
  • Fax: 618-537-6259
Mailing address:
  • Phone: 636-861-1857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: