Provider Demographics
NPI:1417256041
Name:HAND AND OCCUPATIONAL THERAPY CENTER
Entity Type:Organization
Organization Name:HAND AND OCCUPATIONAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BRANNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-235-0877
Mailing Address - Street 1:2767 OFFICE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1143
Mailing Address - Country:US
Mailing Address - Phone:334-239-9431
Mailing Address - Fax:334-239-9415
Practice Address - Street 1:2767 OFFICE PARK CIR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-1143
Practice Address - Country:US
Practice Address - Phone:334-239-9431
Practice Address - Fax:334-239-9415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2182225XH1200X
AL0249225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty