Provider Demographics
NPI:1154507929
Name:CARROLL HAND THERAPY
Entity Type:Organization
Organization Name:CARROLL HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:505-248-1586
Mailing Address - Street 1:5250 EUBANK BLVD. NE
Mailing Address - Street 2:SUITE B-49/158
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2087
Mailing Address - Country:US
Mailing Address - Phone:505-248-1586
Mailing Address - Fax:505-248-1722
Practice Address - Street 1:8400 OSUNA RD NE
Practice Address - Street 2:SUITE 3-C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2087
Practice Address - Country:US
Practice Address - Phone:505-248-1586
Practice Address - Fax:505-248-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM154261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center