Provider Demographics
NPI:1184036741
Name:HANCOCK, MONICA ANN (PT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ANN
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 OLIVE CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-8586
Mailing Address - Country:US
Mailing Address - Phone:919-535-8758
Mailing Address - Fax:
Practice Address - Street 1:905 OLD WINSTON RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-6639
Practice Address - Country:US
Practice Address - Phone:336-992-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14909OtherNC BOARD OF PT EXAMINERS