Healthcare Provider Details

I. General information

NPI: 1447493374
Provider Name (Legal Business Name): PREMIER HAND THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 S BELLAIRE ST SUITE 120
DENVER CO
80222-4306
US

IV. Provider business mailing address

362 THORN APPLE WAY
CASTLE ROCK CO
80108-8255
US

V. Phone/Fax

Practice location:
  • Phone: 720-255-5655
  • Fax:
Mailing address:
  • Phone: 303-660-7914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number1071100083
License Number StateCO

VIII. Authorized Official

Name: MS. HOLLY E JOHNSTON
Title or Position: OWNER
Credential: OTR, CHT
Phone: 720-255-5655