Provider Demographics
NPI:1841251022
Name:ALEXANDRIA UPPER EXTREMITY & HAND THERAPY
Entity type:Organization
Organization Name:ALEXANDRIA UPPER EXTREMITY & HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOHROR-HILL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:320-763-4263
Mailing Address - Street 1:4595 COUNTY ROAD 78 SE
Mailing Address - Street 2:
Mailing Address - City:OSAKIS
Mailing Address - State:MN
Mailing Address - Zip Code:56360-8054
Mailing Address - Country:US
Mailing Address - Phone:320-763-4263
Mailing Address - Fax:
Practice Address - Street 1:1500 IRVING ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2515
Practice Address - Country:US
Practice Address - Phone:320-763-4263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101146225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN252J3ALOtherBLUECROSS AND BLUESHIEL
MN6403627OtherMEDIA
MNC03820Medicare ID - Type Unspecified