Individual
JOHN HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
121 N MAIN ST STE B, TAYLOR, AZ 85939-2486
(928) 536-9933
(928) 536-9935
Mailing address
PO BOX 1420, SHOW LOW, AZ 85902-1420
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-009365
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209015
—
AZ
Enumeration date
10/23/2023
Last updated
06/29/2025
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