MEDICARE: ARMWORKS SPLINTING SERVICES

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
1	225XH1200X	Hand Occupational Therapist	1023386	OR

General Provider Information

NPI Number	:	1346559598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARMWORKS SPLINTING SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 2485
Second Line	:
City	:	GRESHAM
State	:	OR
Zip	:	97030-0660
Country	:	US
Telephone Number	:	503-674-7860
Fax Number	:	503-674-7642

Provider Business Practice Location Address
First Line	:	16126 SE HAPPY VALLEY TOWN CENTER DR
Second Line	:	SUITE 200, BUILDING J
City	:	HAPPY VALLEY
State	:	OR
Zip	:	97086-4256
Country	:	US
Telephone Number	:	503-427-2956
Fax Number	:	503-427-2957

Authorized Official
Title or Position	:	OWNER
Name	:	RYAN DOUGLAS GLOVER
Credential	:	OTR/L
Telephone Number	:	503-674-7860

Provider Enumeration Date	:	10/05/2010
Last Update Date	:	10/05/2010

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