Healthcare Provider Details

I. General information

NPI: 1154180867
Provider Name (Legal Business Name): HANNAH KLEEHAMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 NEWBERRY RD
GAINESVILLE FL
32607-2249
US

IV. Provider business mailing address

4820 NEWBERRY RD
GAINESVILLE FL
32607-2249
US

V. Phone/Fax

Practice location:
  • Phone: 352-264-2499
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: