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General NPI Number Information
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NPI Number | 1295900231
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Entity Type | Organization
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Legal Business Name | AWESOME HANDS HEALTH SERVICE
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 522 9TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-2048
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Country | US
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Telephone | 941-747-0999
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Fax | 941-747-7839
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Provider Business Mailing Address
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Address Line | 522 9TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-2048
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Country | US
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Telephone | 941-747-0999
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Fax | 941-747-7839
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TINA CAROL BOYERS
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Credential |
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Telephone | 941-747-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 230507
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License Number State | FL
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