Provider Demographics
NPI:1750940102
Name:STROM, HANNAH (PT)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:STROM
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 1:7825 3RD ST N
Mailing Address - Street 2:STE 105
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-5444
Mailing Address - Country:US
Mailing Address - Phone:528-354-5129
Mailing Address - Fax:952-516-5655
Practice Address - Street 1:9242 HUDSON BLVD
Practice Address - Street 2:STE 400
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-8701
Practice Address - Country:US
Practice Address - Phone:952-835-4512
Practice Address - Fax:952-516-5655
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14741-24225100000X
MN11471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist