MEDICARE: SAN JUAN HAND THERAPY, INC.

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	225X00000X	Occupational Therapist
2	225XH1200X	Hand Occupational Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	670002078	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952471856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JUAN HAND THERAPY, INC.

Provider Business Mailing Address
First Line	:	575 RIVERGATE LANE
Second Line	:	SUITE 108
City	:	DURANGO
State	:	CO
Zip	:	81301-7490
Country	:	US
Telephone Number	:	970-247-7711
Fax Number	:	970-247-1415

Provider Business Practice Location Address
First Line	:	575 RIVERGATE LANE
Second Line	:	SUITE 108
City	:	DURANGO
State	:	CO
Zip	:	81301-7490
Country	:	US
Telephone Number	:	970-247-7711
Fax Number	:	970-247-1415

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY E SINNOTT-OSWALD
Credential	:	MS, OTR, CHT
Telephone Number	:	970-247-7711

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/28/2017

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Directions to “SAN JUAN HAND THERAPY, INC. ” Practice Location

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