Provider Demographics
NPI:1861237539
Name:SOMA HAND THERAPY - CLARKSVILLE
Entity type:Organization
Organization Name:SOMA HAND THERAPY - CLARKSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUNO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT, CFCE
Authorized Official - Phone:615-800-8017
Mailing Address - Street 1:1161 MURFREESBORO PIKE STE 410
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2234
Mailing Address - Country:US
Mailing Address - Phone:615-800-8017
Mailing Address - Fax:615-469-4189
Practice Address - Street 1:2443 OLD RUSSELLVILLE PIKE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5833
Practice Address - Country:US
Practice Address - Phone:615-800-8017
Practice Address - Fax:615-469-4189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOMA HAND THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty