Provider Demographics
NPI:1205079266
Name:HANCOCK, DARRYL ARTHUR (PT)
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:ARTHUR
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 HILLS AND DALES RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-6220
Mailing Address - Country:US
Mailing Address - Phone:330-477-9720
Mailing Address - Fax:330-458-4610
Practice Address - Street 1:4650 HILLS AND DALES RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-6220
Practice Address - Country:US
Practice Address - Phone:330-477-9720
Practice Address - Fax:330-458-4610
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT007022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist