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General NPI Number Information
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NPI Number | 1023298999
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Entity Type | Organization
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Legal Business Name | SUMMIT HAND THERAPY LLC
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 2179 N 1700 W SUITE 5
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City | LAYTON
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State | UT
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Zip | 84041-1138
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Country | US
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Telephone | 801-773-2633
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Fax | 801-773-1553
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Provider Business Mailing Address
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Address Line | 2179 N 1700 W SUITE 5
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City | LAYTON
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State | UT
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Zip | 84041-1138
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Country | US
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Telephone | 801-773-2633
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Fax | 801-773-1553
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL J DELONG
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Credential | OTD, OTR/L
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Telephone | 801-773-2633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 6717526-4201
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License Number State | UT
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