Provider Demographics
NPI:1902094071
Name:MIDWEST HAND THERAPY, INC
Entity Type:Organization
Organization Name:MIDWEST HAND THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, TREATING THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PAULSON
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CHT
Authorized Official - Phone:816-532-3400
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-0655
Mailing Address - Country:US
Mailing Address - Phone:816-532-3400
Mailing Address - Fax:816-532-3401
Practice Address - Street 1:1014 S US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-9321
Practice Address - Country:US
Practice Address - Phone:816-532-3400
Practice Address - Fax:816-532-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-13
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000160749225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1912918806OtherPERSONAL NPI