Provider Demographics
NPI:1831387414
Name:CATALINA HAND AND SHOULDER THERAPY, PC
Entity type:Organization
Organization Name:CATALINA HAND AND SHOULDER THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:520-400-0726
Mailing Address - Street 1:4172 W PYRACANTHA CIR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-1339
Mailing Address - Country:US
Mailing Address - Phone:529-293-5252
Mailing Address - Fax:520-293-5454
Practice Address - Street 1:437 W THURBER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-6822
Practice Address - Country:US
Practice Address - Phone:520-293-5252
Practice Address - Fax:520-293-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1867225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6013520001Medicare NSC
AZ108729Medicare PIN