Provider Demographics
NPI:1114102845
Name:HAND THERAPY ASSOCIATES OF GEORGIA
Entity Type:Organization
Organization Name:HAND THERAPY ASSOCIATES OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LUPIEN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:770-425-2151
Mailing Address - Street 1:5041 DALLAS HWY
Mailing Address - Street 2:BLDG 1, SUITE C
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6458
Mailing Address - Country:US
Mailing Address - Phone:770-425-2151
Mailing Address - Fax:770-425-5982
Practice Address - Street 1:5041 DALLAS HWY
Practice Address - Street 2:BLDG 1, SUITE C
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6458
Practice Address - Country:US
Practice Address - Phone:770-425-2151
Practice Address - Fax:770-425-5982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000594225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7271OtherPTAN