Provider Demographics
NPI:1306315072
Name:KLOOSTERMAN, HANNAH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:KLOOSTERMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 EGLIN PKWY SE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-5899
Mailing Address - Country:US
Mailing Address - Phone:850-200-4350
Mailing Address - Fax:
Practice Address - Street 1:220 EGLIN PKWY SE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-5899
Practice Address - Country:US
Practice Address - Phone:850-200-4348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-24
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT378962251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics