Provider Demographics
NPI:1831745975
Name:SUMMIT HAND THERAPY
Entity type:Organization
Organization Name:SUMMIT HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE/BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-866-9766
Mailing Address - Street 1:1992 W ANTELOPE DR STE 1D
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4974
Mailing Address - Country:US
Mailing Address - Phone:801-773-2633
Mailing Address - Fax:801-773-1553
Practice Address - Street 1:1030 MEDICAL DR STE B
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3276
Practice Address - Country:US
Practice Address - Phone:801-866-9766
Practice Address - Fax:801-773-1553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty