Healthcare Provider Details

I. General information

NPI: 1518382357
Provider Name (Legal Business Name): PHYSICAL THERAPY AND HAND SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 N CHURCH STREET STE 201
GREENSBORO NC
27401-1041
US

IV. Provider business mailing address

8823 PRODUCTION LANE
OOLTEWAH TN
37363
US

V. Phone/Fax

Practice location:
  • Phone: 336-375-4263
  • Fax: 336-275-2286
Mailing address:
  • Phone: 423-238-8923
  • Fax: 423-954-7399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAVID VANNAME
Title or Position: CEO
Credential:
Phone: 423-238-7217