Healthcare Provider Details
I. General information
NPI: 1295321149
Provider Name (Legal Business Name): THIES HAND THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2020
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9377 E BELL RD STE 101
SCOTTSDALE AZ
85260-1503
US
IV. Provider business mailing address
9377 E BELL RD STE 101
SCOTTSDALE AZ
85260-1503
US
V. Phone/Fax
- Phone: 602-689-6538
- Fax:
- Phone: 602-689-6538
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
THIES
Title or Position: OWNER
Credential: OT
Phone: 602-689-6538