Doctor Name: | KELLI MARIE HANSEN |
NPI Number: | 1477802999 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 2012023610 |
Business Practice Address: | 3955 Summer Forest Dr Saint Charles, MO - 633042643 |
Business Phone Number: | 6364484404 |
Business Fax Number: | |
Mailing Address: | 1420 Bridgeport Ter, SAINT CHARLES |
State: | MO |
Postal Code: | 633034850 |
Phone Number: | 6364484404 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2012 |
NPI Last Update Date: | 10/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2012023610 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |