Individual
CHERYL D HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
KCSA
Contact information
Practice address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-7200
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
(270) 825-7200
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
SA076
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA076
LICENSE
KY
Enumeration date
11/02/2006
Last updated
07/08/2007
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