Provider Demographics
NPI:1679120315
Name:HANKS, JOSEPH CLARK (DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CLARK
Last Name:HANKS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 LEAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-3349
Mailing Address - Country:US
Mailing Address - Phone:502-223-7403
Mailing Address - Fax:502-223-5016
Practice Address - Street 1:1100 GLENSBORO RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9083
Practice Address - Country:US
Practice Address - Phone:502-839-9755
Practice Address - Fax:502-839-9763
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006736208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation