Organization
GEORGIA SOUTH HAND THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUCY THOMAS (OFFICE/BILLING MANAGER)
(770) 474-4595
Entity
Organization
Contact information
Practice address
7444 HANNOVER PKWY S, SUITE 250, STOCKBRIDGE, GA 30281-9303
(770) 474-4595
(770) 474-4182
Mailing address
7444 HANNOVER PKWY S, SUITE 250, STOCKBRIDGE, GA 30281-9303
(770) 474-4595
(770) 474-4182
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#P-11215765
MULTI PLAN HEALTH
GA
05
—
253024492A
—
GA
01
—
612611600
DEPT OF LABOR
GA
01
—
670002188
RAILROAD MEDICARE
GA
01
—
7921605
AETNA HEALTH INS
GA
Enumeration date
10/06/2006
Last updated
10/01/2009
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