Provider Demographics
NPI:1679736052
Name:HAHN, RODNEY DALE (PT)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:DALE
Last Name:HAHN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 JESSICA LN
Mailing Address - Street 2:
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-2232
Mailing Address - Country:US
Mailing Address - Phone:608-768-3333
Mailing Address - Fax:608-768-3335
Practice Address - Street 1:344 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-2040
Practice Address - Country:US
Practice Address - Phone:608-768-3333
Practice Address - Fax:608-768-3335
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3535-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist