Provider Demographics
NPI:1760424246
Name:HAND CLINIC, INC
Entity Type:Organization
Organization Name:HAND CLINIC, INC
Other - Org Name:TRUSSVILLE HAND CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L, CSCS
Authorized Official - Phone:205-661-0810
Mailing Address - Street 1:PO BOX 723
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-0723
Mailing Address - Country:US
Mailing Address - Phone:205-960-9995
Mailing Address - Fax:205-661-9841
Practice Address - Street 1:4901 DEERFOOT PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-2697
Practice Address - Country:US
Practice Address - Phone:205-960-9995
Practice Address - Fax:205-661-9841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5711040001Medicare NSC