Provider Demographics
NPI:1952471856
Name:SAN JUAN HAND THERAPY, INC.
Entity Type:Organization
Organization Name:SAN JUAN HAND THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SINNOTT-OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR, CHT
Authorized Official - Phone:970-247-7711
Mailing Address - Street 1:575 RIVERGATE LANE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7490
Mailing Address - Country:US
Mailing Address - Phone:970-247-7711
Mailing Address - Fax:970-247-1415
Practice Address - Street 1:575 RIVERGATE LANE
Practice Address - Street 2:SUITE 108
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7490
Practice Address - Country:US
Practice Address - Phone:970-247-7711
Practice Address - Fax:970-247-1415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19001754Medicaid
670002078OtherMEDICARE RAILROAD
CO19001754Medicaid
CO4746110001Medicare NSC