Healthcare Provider Details

I. General information

NPI: 1245596162
Provider Name (Legal Business Name): HANDS ON THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3065 COLLEGE RD
FAIRBANKS AK
99709-3702
US

IV. Provider business mailing address

3065 COLLEGE RD
FAIRBANKS AK
99709-3702
US

V. Phone/Fax

Practice location:
  • Phone: 907-699-3160
  • Fax: 79-374-1659
Mailing address:
  • Phone: 907-374-1686
  • Fax: 907-374-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2089
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA BALVANZ
Title or Position: OWNER/THERAPIST
Credential: OTR/L
Phone: 907-699-3160