Provider Demographics
NPI:1508076100
Name:MARY K HUBBELL
Entity Type:Organization
Organization Name:MARY K HUBBELL
Other - Org Name:CENTER FOR HAND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:HUBBELL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR CHT
Authorized Official - Phone:303-830-8226
Mailing Address - Street 1:1721 E 19TH AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1242
Mailing Address - Country:US
Mailing Address - Phone:303-830-8226
Mailing Address - Fax:303-860-9048
Practice Address - Street 1:1721 E 19TH AVE
Practice Address - Street 2:STE 220
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1242
Practice Address - Country:US
Practice Address - Phone:303-830-8226
Practice Address - Fax:303-860-9048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA201590332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28836871Medicaid
CO28836871Medicaid
COC469798Medicare PIN