Provider Demographics
NPI:1093043291
Name:HAND & PHYSICAL REHAB, PLLC
Entity Type:Organization
Organization Name:HAND & PHYSICAL REHAB, PLLC
Other - Org Name:HAND REHABILTATION SERVICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CHT
Authorized Official - Phone:502-895-3972
Mailing Address - Street 1:2932 BRECKENRIDGE LN
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1409
Mailing Address - Country:US
Mailing Address - Phone:502-895-3972
Mailing Address - Fax:502-897-5299
Practice Address - Street 1:2932 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 10
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1409
Practice Address - Country:US
Practice Address - Phone:502-895-3972
Practice Address - Fax:502-897-5299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-27
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0004682251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0229270001Medicare NSC