Provider Demographics
NPI:1598097560
Name:SOUTHWEST HAND THERAPY SPECIALISTS,INC
Entity Type:Organization
Organization Name:SOUTHWEST HAND THERAPY SPECIALISTS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:OTPT
Authorized Official - Phone:760-791-6498
Mailing Address - Street 1:1311 CHERRY TREE CIR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6909
Mailing Address - Country:US
Mailing Address - Phone:714-470-4354
Mailing Address - Fax:
Practice Address - Street 1:1463 S 4TH ST
Practice Address - Street 2:STE B
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4749
Practice Address - Country:US
Practice Address - Phone:760-791-1936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0T4938225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty