Healthcare Provider Details

I. General information

NPI: 1124101167
Provider Name (Legal Business Name): DESERT HAND THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 W THUNDERBIRD RD 465
GLENDALE AZ
85306-4641
US

IV. Provider business mailing address

690 N COFCO CENTER CT 260
PHOENIX AZ
85008-6462
US

V. Phone/Fax

Practice location:
  • Phone: 602-843-9945
  • Fax: 888-445-4263
Mailing address:
  • Phone: 602-279-6905
  • Fax: 888-445-4263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0880
License Number StateAZ

VIII. Authorized Official

Name: ARMIEDA HUFF
Title or Position: CREDENTIALING
Credential:
Phone: 602-279-6905