Provider Demographics
NPI:1326219353
Name:MAHONING VALLEY HAND THERAPY
Entity Type:Organization
Organization Name:MAHONING VALLEY HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARSHBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:L/OTR
Authorized Official - Phone:330-204-1217
Mailing Address - Street 1:PO BOX 1376
Mailing Address - Street 2:MAHONING VALLEY HAND THERAPY
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44501-1376
Mailing Address - Country:US
Mailing Address - Phone:330-204-1217
Mailing Address - Fax:440-985-3308
Practice Address - Street 1:45 N CANFIELD NILES RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2343
Practice Address - Country:US
Practice Address - Phone:330-204-1217
Practice Address - Fax:440-985-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMASP00802Medicare PIN