Healthcare Provider Details

I. General information

NPI: 1881928158
Provider Name (Legal Business Name): CARLA CALLICUTT HANKINS M.S., PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 S HUGHES ST
APEX NC
27502-7731
US

IV. Provider business mailing address

1428 BIG LEAF LOOP
APEX NC
27502-4086
US

V. Phone/Fax

Practice location:
  • Phone: 919-362-6121
  • Fax:
Mailing address:
  • Phone: 919-303-7957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number9087
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: