Individual
KASSI LEE HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Mailing address
203 WILLIAMS ST, ANNA, IL 62906-1837
(618) 694-8764
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2072726
TX
Other
Enumeration date
08/14/2009
Last updated
06/28/2012
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