Organization
TRISTATE HAND AND OCCUPATIONAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN J WODASKI MS OTR L CHT (PRESIDENT)
(301) 759-4263
Entity
Organization
Contact information
Practice address
200 GLENN ST, STE 200, CUMBERLAND, MD 21502-2436
(301) 759-4263
(301) 759-4461
Mailing address
PO BOX 1517, CUMBERLAND, MD 21501-1517
(301) 759-4263
(301) 759-4461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045607
WORKERS COMP
WV
01
—
1755801
UHC
—
01
—
215904
TRIGON ANTHEM
VA
01
—
271417
MAMSI MDIPA OPTIMUM CHOIC
—
05
—
3810001817
—
WV
01
—
64 00216
UNC MID ATLANTIC
—
01
—
6637055 001
CIGNA PPO HMO
—
05
—
834200801
—
MD
01
—
LN87TR
CALEFIRST
MD
01
—
N0336
WORKERS COMP
MD
01
—
R689
CALEFIRST
MD
Enumeration date
12/20/2005
Last updated
09/16/2008
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