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General NPI Number Information
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NPI Number | 1831792001
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Entity Type | Organization
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Legal Business Name | HANDS ON THERAPY - PT, LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 3065 COLLEGE RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-3702
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Country | US
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Telephone | 907-374-1689
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 COLLEGE RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-3702
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Country | US
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Telephone | 907-374-1689
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MELISSA BALVANZ
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Credential | OTR/L, C/NDT
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Telephone | 907-374-1689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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