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General NPI Number Information
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NPI Number | 1891879912
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Entity Type | Organization
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Legal Business Name | ISLAND HAND & UPPER BODY REHABILITATION
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/13/2019
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Provider Practice Location Address
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Address Line | 3210 N. CROATAN HWY STE 3, 2ND FLOOR
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City | KILL DEVIL HILLS
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State | NC
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Zip | 27948-8516
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Country | US
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Telephone | 252-255-5252
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Fax | 252-480-0943
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Provider Business Mailing Address
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Address Line | PO BOX 7393
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City | KILL DEVIL HILLS
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State | NC
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Zip | 27948-7393
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Country | US
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Telephone | 252-255-5252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL D CALHOUN
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Credential | OTRL
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Telephone | 252-255-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2161
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License Number State | NC
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