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General NPI Number Information
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NPI Number | 1649488628
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Entity Type | Individual
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Provider Name | CRAIG PHILIP HANCOCK NMT, PT
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1490 BOULEVARD OF THE ARTS
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City | SARASOTA
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State | FL
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Zip | 34236-2905
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Country | US
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Telephone | 941-266-0853
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Fax | 941-794-2931
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Provider Business Mailing Address
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Address Line | 5319 13TH AVENUE DR W
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City | BRADENTON
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State | FL
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Zip | 34209-4237
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Country | US
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Telephone | 941-266-0853
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Fax | 941-794-2931
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA0026260
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License Number State | FL
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