MEDICARE: DYNAMIC REHAB HAND THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist
2	225XH1200X	Hand Occupational Therapist

General Provider Information

NPI Number	:	1184631889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC REHAB HAND THERAPY, INC.

Provider Business Mailing Address
First Line	:	3303 S LINDSAY RD STE 116
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-2100
Country	:	US
Telephone Number	:	480-782-9696
Fax Number	:	480-782-1760

Provider Business Practice Location Address
First Line	:	3303 S LINDSAY RD STE 116
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-2100
Country	:	US
Telephone Number	:	480-782-9696
Fax Number	:	480-782-1760

Authorized Official
Title or Position	:	OWNER, HAND THERAPIST
Name	:	MRS. ANNETTE MARIE MONACCIO
Credential	:	OTR/L, CHT
Telephone Number	:	480-782-9696

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/17/2008

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