Provider Demographics
NPI:1306220215
Name:HANDS ON THERAPY
Entity Type:Organization
Organization Name:HANDS ON THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HAZELINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:916-332-1505
Mailing Address - Street 1:5905 CANARY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-4707
Mailing Address - Country:US
Mailing Address - Phone:916-332-1505
Mailing Address - Fax:916-339-9082
Practice Address - Street 1:5905 CANARY DR
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-4707
Practice Address - Country:US
Practice Address - Phone:916-332-1505
Practice Address - Fax:916-339-9082
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANDS ON THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT190140273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit