Organization
MID-PENINSULA HAND REHABILITATION & ERGONOMICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI KAY STOTKO OTR CHT (CEO)
(650) 245-2844
Entity
Organization
Contact information
Practice address
1155 UNIVERSITY DR, BUILDING 1, MENLO PARK, CA 94025-4431
(650) 245-2844
(650) 712-0419
Mailing address
1155 UNIVERSITY DR, BUILDING 1, MENLO PARK, CA 94025-4431
(650) 245-2844
(650) 712-0419
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
521
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FD906A
MEDICARE PTAN
—
Enumeration date
07/14/2011
Last updated
08/29/2011
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