MEDICARE: RYAN DOUGLAS GLOVER ARMWORKS HAND THERAPY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	225XH1200X	Hand Occupational Therapist

General Provider Information

NPI Number	:	1689995896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYAN DOUGLAS GLOVER ARMWORKS HAND THERAPY

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	:	#200-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	:	BUSINESS MANAGER
Name	:	JENNE MARIE GLOVER
Credential	:
Telephone Number	:	503-674-7860

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	02/22/2011

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