Healthcare Provider Details

I. General information

NPI: 1578786521
Provider Name (Legal Business Name): HAND THERAPY SPECIALISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 CHURCH ST NE SUITE G
VIENNA VA
22180-4737
US

IV. Provider business mailing address

407 CHURCH ST NE SUITE G
VIENNA VA
22180-4737
US

V. Phone/Fax

Practice location:
  • Phone: 703-255-2339
  • Fax: 703-255-2402
Mailing address:
  • Phone: 703-255-2339
  • Fax: 703-255-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0119000683
License Number StateVA

VIII. Authorized Official

Name: MRS. VIVIAN G CAUDILL
Title or Position: OFFICE MANAGER
Credential:
Phone: 703-255-2339