Provider Demographics
NPI:1891845376
Name:LUBBOCK HAND THERAPY PLLC
Entity Type:Organization
Organization Name:LUBBOCK HAND THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FENNERTY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, CHT
Authorized Official - Phone:806-777-8605
Mailing Address - Street 1:PO BOX 64240
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79464-4240
Mailing Address - Country:US
Mailing Address - Phone:806-771-7451
Mailing Address - Fax:806-771-7448
Practice Address - Street 1:6310 GENOA AVE STE G
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2708
Practice Address - Country:US
Practice Address - Phone:806-771-7451
Practice Address - Fax:806-771-7451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX19LJOtherBCBS OF TEXAS
TX00249XMedicare PIN