Provider Demographics
NPI:1073251526
Name:KENNEASTER, HANNAH MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:KENNEASTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:WILLHOITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3114 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1031
Mailing Address - Country:US
Mailing Address - Phone:210-833-5690
Mailing Address - Fax:
Practice Address - Street 1:3106 S W S YOUNG DR STE A102
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-2000
Practice Address - Country:US
Practice Address - Phone:254-628-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1357264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist