Provider Demographics
NPI:1912116138
Name:HARTMAN, ALBERT H (OTR)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:H
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901
Mailing Address - Country:US
Mailing Address - Phone:785-243-5089
Mailing Address - Fax:
Practice Address - Street 1:1110 W 11TH ST
Practice Address - Street 2:MOUNT JOSEPH SENIOR VILLAGE
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901
Practice Address - Country:US
Practice Address - Phone:785-243-4699
Practice Address - Fax:785-243-4699
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1701242225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist