Provider Demographics
NPI:1669692679
Name:HARDY, KERRI L (PT DPT)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:L
Last Name:HARDY
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:L
Other - Last Name:ZIETLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 WESTOWN PKWY
Mailing Address - Street 2:STE 107
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1540
Mailing Address - Country:US
Mailing Address - Phone:515-440-3439
Mailing Address - Fax:515-440-3832
Practice Address - Street 1:2001 WESTOWN PKWY
Practice Address - Street 2:STE 107
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-1540
Practice Address - Country:US
Practice Address - Phone:515-440-3439
Practice Address - Fax:515-440-3832
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02274225100000X
IA2274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist