Provider Demographics
NPI:1346571916
Name:NORTHERN KENTUCKY HAND THERAPY CENTER
Entity Type:Organization
Organization Name:NORTHERN KENTUCKY HAND THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZINSER-BOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:859-331-4263
Mailing Address - Street 1:4495 MCKEEVER PIKE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45176-9559
Mailing Address - Country:US
Mailing Address - Phone:513-724-7122
Mailing Address - Fax:859-344-1711
Practice Address - Street 1:545 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3444
Practice Address - Country:US
Practice Address - Phone:859-331-4263
Practice Address - Fax:859-344-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6318620001Medicare NSC