Provider Demographics
NPI:1023476926
Name:HANSEN, KRISTA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:MARIE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:MARIE
Other - Last Name:HANNASCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-1932
Mailing Address - Fax:630-928-5032
Practice Address - Street 1:3160 8TH ST SW
Practice Address - Street 2:STE M & N
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1023
Practice Address - Country:US
Practice Address - Phone:515-967-4580
Practice Address - Fax:515-967-4899
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist