Provider Demographics
NPI:1891118626
Name:SPOONER NORTH WEST HAND THERAPY, P.C.
Entity Type:Organization
Organization Name:SPOONER NORTH WEST HAND THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, FAFS
Authorized Official - Phone:602-527-0586
Mailing Address - Street 1:9097 E DESERT COVE AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6279
Mailing Address - Country:US
Mailing Address - Phone:480-551-4961
Mailing Address - Fax:480-860-0356
Practice Address - Street 1:15830 N 35TH AVE
Practice Address - Street 2:STE 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-7640
Practice Address - Country:US
Practice Address - Phone:602-507-6989
Practice Address - Fax:602-507-6994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty