MEDICARE: DEBORAH L HANKS RPT

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	300	AL

General Provider Information

NPI Number	:	1841351558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH L HANKS RPT

Provider Business Mailing Address
First Line	:	2973 PHELAN CIR SE
Second Line	:
City	:	HANCEVILLE
State	:	AL
Zip	:	35077-7547
Country	:	US
Telephone Number	:	256-590-7910
Fax Number	:

Provider Business Practice Location Address
First Line	:	2326 MORGAN AVE SW
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-6244
Country	:	US
Telephone Number	:	256-340-0333
Fax Number	:	256-340-0005

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	06/10/2013

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