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General NPI Number Information
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NPI Number | 1972475408
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Entity Type | Organization
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Legal Business Name | ABBIE LAYCOCK DPT LLC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 805 OAKHURST DR STE A
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City | EVANS
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State | GA
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Zip | 30809-3712
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Country | US
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Telephone | 330-844-1945
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 WALTONS PASS
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City | EVANS
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State | GA
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Zip | 30809-8247
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABBIE LAYCOCK
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Credential |
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Telephone | 330-844-1945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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