Victoria Hensley

Individual provider Active NPI Physical Therapy Assistant · Cochran, GA

NPI 1043787716 · NPPES record last updated Jun 15, 2020

Key facts

NPI
1043787716
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA004084 (GA)
Practice address
134 S 6TH St
Cochran, GA 31014-6626
Phone
(478) 934-7682
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA004084GAMDPhysical Therapy Assistant
A5311NCMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A5311 NC
Physical Therapy Assistant 225200000X PTA004084 GA Yes

Addresses

Primary practice location

134 S 6TH St
Cochran, GA 31014-6626

Mailing address

425 Sycamore Dr
Eastman, GA 31023-3791

Other providers in Cochran, GA

All providers in Cochran, GA · Physical Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.