MEDICARE: HANDS ON THERAPY SPECIALISTS, LLC

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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1689776817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDS ON THERAPY SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	W227N16857 TILLIE LAKE CT
Second Line	:
City	:	JACKSON
State	:	WI
Zip	:	53037-9000
Country	:	US
Telephone Number	:	262-677-8501
Fax Number	:	262-677-2876

Provider Business Practice Location Address
First Line	:	W227N16861 TILLIE LAKE CT
Second Line	:
City	:	JACKSON
State	:	WI
Zip	:	53037-9000
Country	:	US
Telephone Number	:	262-677-8501
Fax Number	:	262-677-2876

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RHONDA ELLIOTT
Credential	:	OTR
Telephone Number	:	262-677-8501

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	06/05/2008

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