Provider Demographics
NPI:1215398425
Name:FORT SMITH HAND THERAPY LLC
Entity Type:Organization
Organization Name:FORT SMITH HAND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HONAKER
Authorized Official - Suffix:III
Authorized Official - Credentials:OT
Authorized Official - Phone:479-226-2949
Mailing Address - Street 1:6301 HIGHWAY 45
Mailing Address - Street 2:SUITE G
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-8851
Mailing Address - Country:US
Mailing Address - Phone:479-226-2949
Mailing Address - Fax:
Practice Address - Street 1:6301 HIGHWAY 45
Practice Address - Street 2:SUITE G
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-8851
Practice Address - Country:US
Practice Address - Phone:479-226-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR853261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine