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General NPI Number Information
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NPI Number | 1851653901
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Entity Type | Organization
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Legal Business Name | ADVANCED HAND THERAPY PC
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 840 ADDISON AVE
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City | TWIN FALLS
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State | ID
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Zip | 83301-5203
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Country | US
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Telephone | 208-595-4941
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Fax | 208-731-1582
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Provider Business Mailing Address
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Address Line | 840 ADDISON AVE
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City | TWIN FALLS
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State | ID
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Zip | 83301-5203
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Country | US
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Telephone | 208-595-4941
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | LESLEY S RUBY
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Credential | OTR/L CHT
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Telephone | 208-595-4941
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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 | OT 242
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License Number State | ID
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