Provider Demographics
NPI:1235486754
Name:HAND THERAPY OF FRESNO, INCORPORATED
Entity Type:Organization
Organization Name:HAND THERAPY OF FRESNO, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KISHIHARA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/CHT
Authorized Official - Phone:559-960-5764
Mailing Address - Street 1:47900 WILLOW POND RD
Mailing Address - Street 2:
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614-8720
Mailing Address - Country:US
Mailing Address - Phone:559-683-5460
Mailing Address - Fax:
Practice Address - Street 1:7120 N WHITNEY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0153
Practice Address - Country:US
Practice Address - Phone:559-323-4831
Practice Address - Fax:559-323-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT3030261QR0400X
CAOT3029261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation