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NPI Code Detail

MEDICARE: COURTNEY MAE HANKO PTA

MEDICARE: COURTNEY MAE HANKO PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant1470019WI

General Provider Information

NPI Number : 1477726461
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY MAE HANKO PTA
Provider Business Mailing Address
First Line : 407 N 8TH ST
Second Line :
City : MOUNT HOREB
State : WI
Zip : 53572-1872
Country : US
Telephone Number : 608-437-5511
Fax Number :
Provider Business Practice Location Address
First Line : 407 N 8TH ST
Second Line :
City : MOUNT HOREB
State : WI
Zip : 53572-1872
Country : US
Telephone Number : 608-437-5511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2008
Last Update Date : 04/10/2008

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Directions to “ COURTNEY MAE HANKO PTA” Practice Location

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