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Individual

DR. KEVIN DALE HANCOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6910 N MAIN ST, UNIT 5, GRANGER, IN 46530-8845
(574) 271-1111
Mailing address
6910 N MAIN ST, UNIT 5, GRANGER, IN 46530-8845
(574) 271-1111

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001251
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200022950A
IN
Enumeration date
11/01/2006
Last updated
11/12/2015
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