Provider Demographics
NPI:1497040869
Name:SUMMIT HAND THERAPY
Entity Type:Organization
Organization Name:SUMMIT HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELONG
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:801-773-2633
Mailing Address - Street 1:1992 W ANTELOPE DR
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4953
Mailing Address - Country:US
Mailing Address - Phone:801-773-2633
Mailing Address - Fax:801-773-1533
Practice Address - Street 1:1992 W ANTELOPE DR
Practice Address - Street 2:SUITE 1-D
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4953
Practice Address - Country:US
Practice Address - Phone:801-773-2633
Practice Address - Fax:801-773-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6604760001Medicare NSC