MEDICARE: JAE HANKS DPT

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
1	225100000X	Physical Therapist	6265	SD

General Provider Information

NPI Number	:	1780516757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAE HANKS DPT

Provider Business Mailing Address
First Line	:	1238 MAIN ST
Second Line	:
City	:	STURGIS
State	:	SD
Zip	:	57785-1541
Country	:	US
Telephone Number	:	605-702-8206
Fax Number	:	605-702-9206

Provider Business Practice Location Address
First Line	:	1238 MAIN ST
Second Line	:
City	:	STURGIS
State	:	SD
Zip	:	57785-1541
Country	:	US
Telephone Number	:	605-702-8206
Fax Number	:	605-702-9206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ JAE HANKS DPT” Practice Location

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