Healthcare Provider Details

I. General information

NPI: 1962855254
Provider Name (Legal Business Name): COMMONWEALTH HAND THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 WALLER AVE STE 275
LEXINGTON KY
40504
US

IV. Provider business mailing address

330 WALLER AVE STE 275
LEXINGTON KY
40504-2930
US

V. Phone/Fax

Practice location:
  • Phone: 859-447-8600
  • Fax: 859-447-8599
Mailing address:
  • Phone: 859-447-8600
  • Fax: 859-447-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateKY

VIII. Authorized Official

Name: MR. DONALD GREGORY PITTS
Title or Position: OWNER
Credential: MS,OTR/L, CHT
Phone: 859-447-8600