MEDICARE: JAMIE HANCOCK PT

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	PT012078	GA

General Provider Information

NPI Number	:	1992186332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE HANCOCK PT

Provider Business Mailing Address
First Line	:	747 S 8TH ST STE D
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4884
Country	:	US
Telephone Number	:	470-935-5560
Fax Number	:	770-999-2794

Provider Business Practice Location Address
First Line	:	747 S 8TH ST STE D
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4884
Country	:	US
Telephone Number	:	470-935-5560
Fax Number	:	770-999-2794

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

Provider Enumeration Date	:	06/11/2015
Last Update Date	:	01/30/2024

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