Individual
EASTER ASIS HANCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1096 PLAZA DR, KISSIMMEE, FL 34743-4069
(407) 758-2371
(407) 277-7859
Mailing address
1096 PLAZA DR, KISSIMMEE, FL 34743-4069
(407) 758-2371
(407) 277-7859
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690189196
—
FL
Enumeration date
09/13/2010
Last updated
09/13/2010
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