Provider Demographics
NPI:1386292225
Name:RADER, HANNAH MAE (DPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MAE
Last Name:RADER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19964 HILLTOP RD STE B
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7317
Mailing Address - Country:US
Mailing Address - Phone:303-840-4667
Mailing Address - Fax:
Practice Address - Street 1:19964 HILLTOP RD STE B
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7317
Practice Address - Country:US
Practice Address - Phone:303-840-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist