Provider Demographics
NPI:1437530300
Name:HOGMIRE, KARA A (PT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:A
Last Name:HOGMIRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 EASTWEST PKWY STE 16
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-5311
Mailing Address - Country:US
Mailing Address - Phone:904-215-3958
Mailing Address - Fax:904-213-8456
Practice Address - Street 1:1835 EASTWEST PKWY STE 16
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-5311
Practice Address - Country:US
Practice Address - Phone:904-215-3958
Practice Address - Fax:904-213-8456
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist