Provider Demographics
NPI: | 1962210344 |
---|---|
Name: | SOUTH HILLS PELVIC HEALTH, L.L.C. |
Entity type: | Organization |
Organization Name: | SOUTH HILLS PELVIC HEALTH, L.L.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OCCUPATIONAL THERAPIST |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | JESSICA |
Authorized Official - Middle Name: | LYNNE |
Authorized Official - Last Name: | HAMMOND |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR/L |
Authorized Official - Phone: | 607-329-2140 |
Mailing Address - Street 1: | 1417 SNEE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | PITTSBURGH |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15236-3448 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 607-329-2140 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1417 SNEE DR |
Practice Address - Street 2: | |
Practice Address - City: | PITTSBURGH |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15236-3448 |
Practice Address - Country: | US |
Practice Address - Phone: | 607-329-2140 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-12-18 |
Last Update Date: | 2024-12-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty |