Provider Demographics
NPI:1003451931
Name:CENTRAL COAST HAND THERAPY
Entity Type:Organization
Organization Name:CENTRAL COAST HAND THERAPY
Other - Org Name:CENTRAL COAST HAND THERAPY, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MODISETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:831-718-7368
Mailing Address - Street 1:4 ROSSI CIR STE 151
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2361
Mailing Address - Country:US
Mailing Address - Phone:831-755-7755
Mailing Address - Fax:831-755-7705
Practice Address - Street 1:4 ROSSI CIR STE 151
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2361
Practice Address - Country:US
Practice Address - Phone:831-755-7755
Practice Address - Fax:831-755-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy