MEDICARE: MINNESOTA HAND REHABILITATION 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	225XH1200X	Hand Occupational Therapist	100573	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4281	OTHER	MN	HEALTH PARTNERS HMO
2	20571MI	OTHER	MN	BCBS OF MN

General Provider Information

NPI Number	:	1912909557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINNESOTA HAND REHABILITATION INC

Provider Business Mailing Address
First Line	:	393 DUNLAP ST N
Second Line	:	SUITE 736
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-4200
Country	:	US
Telephone Number	:	651-646-4263
Fax Number	:	651-646-8010

Provider Business Practice Location Address
First Line	:	393 DUNLAP ST N
Second Line	:	SUITE 736
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-4200
Country	:	US
Telephone Number	:	651-646-4263
Fax Number	:	651-646-8010

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST REGISTERED
Name	:	MS. MICHELLE ANNE REINER
Credential	:	OTR/LCHT
Telephone Number	:	651-646-4263

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	05/28/2008

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