Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Hand |
225XH1200X | 67 | Occupational Therapist in Private Practice | |
Occupational Therapist |
225X00000X | 67 | Occupational Therapist in Private Practice | |
Prosthetic/Orthotic Supplier |
335E00000X | 51 | Medical Supply Company with Orthotist |
| NPI Number | 1609963115 |
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| LBN Legal business name | GEORGIA SOUTH HAND THERAPY, INC | ||||||||||||||||||||
| Authorized official | LUCY THOMAS - (OFFICE/BILLING MANAGER) | ||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||
| Enumeration date | 10/06/2006 | ||||||||||||||||||||
| Last updated | 10/01/2009 - About 17 years ago | ||||||||||||||||||||
| Identifiers |
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