Provider Demographics
NPI:1568551307
Name:ATHENS HAND THERAPY LLC
Entity Type:Organization
Organization Name:ATHENS HAND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L CHT
Authorized Official - Phone:706-546-7073
Mailing Address - Street 1:700 SUNSET DR
Mailing Address - Street 2:STE 301
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2293
Mailing Address - Country:US
Mailing Address - Phone:706-546-7073
Mailing Address - Fax:706-546-7074
Practice Address - Street 1:700 SUNSET DR
Practice Address - Street 2:STE.301
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2293
Practice Address - Country:US
Practice Address - Phone:706-546-7073
Practice Address - Fax:706-546-7074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00600225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5285140001Medicare NSC
GAGRP6754 67BBBKRMedicare ID - Type Unspecified