Provider Demographics
NPI:1538884465
Name:HANOVER HAND AND UPPER EXTREMITY SPECIALIST, LLC
Entity type:Organization
Organization Name:HANOVER HAND AND UPPER EXTREMITY SPECIALIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:717-646-0440
Mailing Address - Street 1:1010 EICHELBERGER ST STE 5
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1374
Mailing Address - Country:US
Mailing Address - Phone:717-646-0440
Mailing Address - Fax:717-646-0444
Practice Address - Street 1:1010 EICHELBERGER ST STE 5
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1374
Practice Address - Country:US
Practice Address - Phone:717-646-0440
Practice Address - Fax:717-646-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherN/A