Provider Demographics
NPI:1962911339
Name:PREMIER HAND THERAPY
Entity type:Organization
Organization Name:PREMIER HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OT, CHT
Authorized Official - Phone:915-249-6767
Mailing Address - Street 1:715 FRONTIER DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8024
Mailing Address - Country:US
Mailing Address - Phone:575-635-3963
Mailing Address - Fax:
Practice Address - Street 1:125 W HAGUE RD STE 310
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5806
Practice Address - Country:US
Practice Address - Phone:915-249-6767
Practice Address - Fax:915-307-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty