Provider Demographics
NPI:1376146555
Name:HANDS ON THERAPY - OT, LLC
Entity Type:Organization
Organization Name:HANDS ON THERAPY - OT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALVANZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, L
Authorized Official - Phone:907-374-1689
Mailing Address - Street 1:3065 COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3702
Mailing Address - Country:US
Mailing Address - Phone:907-374-1689
Mailing Address - Fax:
Practice Address - Street 1:3065 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3702
Practice Address - Country:US
Practice Address - Phone:907-374-1689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANDS ON THERAPY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty