Healthcare Provider Details

I. General information

NPI: 1740084615
Provider Name (Legal Business Name): LYMPH-A-HAND HOLISTIC UPPER EXTREMITY AND ORTHOPEDICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 CORDOVA DR
MOBILE AL
36609-2852
US

IV. Provider business mailing address

1704 CORDOVA DR
MOBILE AL
36609-2852
US

V. Phone/Fax

Practice location:
  • Phone: 646-761-6454
  • Fax:
Mailing address:
  • Phone: 646-761-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: TRACEY DONIRA BATES
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L, CLT, CHT
Phone: 646-761-6454