Provider Demographics
NPI:1447493374
Name:PREMIER HAND THERAPY, LLC
Entity type:Organization
Organization Name:PREMIER HAND THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, CHT
Authorized Official - Phone:720-255-5655
Mailing Address - Street 1:362 THORN APPLE WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8255
Mailing Address - Country:US
Mailing Address - Phone:303-660-7914
Mailing Address - Fax:
Practice Address - Street 1:1777 S BELLAIRE ST
Practice Address - Street 2:SUITE 120
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4306
Practice Address - Country:US
Practice Address - Phone:720-255-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1071100083225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty