# LAKE ERIE HAND THERAPY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649405440
- **Authorized official:** JULIE MIRABELL MS, OT/L (PRESIDENT)
- **Authorized official phone:** (440) 536-2339

## Contact information

- **Practice address:** 1956 W PROSPECT RD, ASHTABULA, OH 44004-6424
- **Practice address phone:** (440) 536-2339
- **Practice address fax:** (440) 964-8805
- **Mailing address:** 1320 WILLOW DR, ASHTABULA, OH 44004-2053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 4347 | OH | Yes |

## Other

- **Enumeration date:** 05/21/2009
- **Last updated:** 05/21/2009