1386675965 NPI number — HANDS ON PHYSICAL THERAPY LLC

Table of content: (NPI 1386675965)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386675965 NPI number — HANDS ON PHYSICAL THERAPY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANDS ON PHYSICAL THERAPY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386675965
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 57
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GOOCHLAND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23063-0057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-556-7181
Provider Business Mailing Address Fax Number:
804-556-7182

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1940 SANDY HOOK RD
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
GOOCHLAND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23063-3107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-556-7181
Provider Business Practice Location Address Fax Number:
804-556-7182
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARTER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
MATTHEW
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
804-556-7181

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305004559 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 225795 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4700104 . This is a "VIRGINIA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 236223 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8945128 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43809 . This is a "CARENET" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com