Provider Demographics
NPI:1649488628
Name:HANCOCK, CRAIG PHILIP (NMT, PT)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:PHILIP
Last Name:HANCOCK
Suffix:
Gender:M
Credentials:NMT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 13TH AVENUE DR W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-4237
Mailing Address - Country:US
Mailing Address - Phone:941-266-0853
Mailing Address - Fax:941-794-2931
Practice Address - Street 1:1490 BOULEVARD OF THE ARTS
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-2905
Practice Address - Country:US
Practice Address - Phone:941-266-0853
Practice Address - Fax:941-794-2931
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0026260174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist