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NPI Code Detail

MEDICARE: HANS HENDRICK OTR/L

MEDICARE: HANS HENDRICK OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0119001653VA

General Provider Information

NPI Number : 1083021331
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANS HENDRICK OTR/L
Provider Business Mailing Address
First Line : 12721 PERCIVAL ST
Second Line :
City : CHESTER
State : VA
Zip : 23831-4738
Country : US
Telephone Number : 804-717-2134
Fax Number :
Provider Business Practice Location Address
First Line : 12001 IRON BRIDGE RD
Second Line :
City : CHESTER
State : VA
Zip : 23831-1460
Country : US
Telephone Number : 804-706-1023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2014
Last Update Date : 07/18/2014

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Directions to “ HANS HENDRICK OTR/L” Practice Location

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