Provider Demographics
NPI:1992186332
Name:HANCOCK, JAMIE (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
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 1:747 S 8TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4884
Mailing Address - Country:US
Mailing Address - Phone:470-935-5560
Mailing Address - Fax:770-999-2794
Practice Address - Street 1:747 S 8TH ST STE D
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4884
Practice Address - Country:US
Practice Address - Phone:470-935-5560
Practice Address - Fax:770-999-2794
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist