Basic Information
| Provider Information | |||||||||
| NPI: | 1346571916 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHERN KENTUCKY HAND THERAPY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4495 MCKEEVER PIKE | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451769559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137247122 | ||||||||
| FaxNumber: | 8593441711 | ||||||||
| Practice Location | |||||||||
| Address1: | 545 CENTRE VIEW BLVD | ||||||||
| Address2: | |||||||||
| City: | CRESTVIEW HILLS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410173444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593314263 | ||||||||
| FaxNumber: | 8593441711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2010 | ||||||||
| LastUpdateDate: | 05/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | ZINSER-BOURNE | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8593314263 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OTR/L, CHT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XH1200X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
No ID Information.