Healthcare Provider Details

I. General information

NPI: 1083318836
Provider Name (Legal Business Name): HANNAH MARIE BARGMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1643 N ALPINE RD
ROCKFORD IL
61107-1462
US

IV. Provider business mailing address

4616 RED BLUFF DR
ROCKFORD IL
61107-3715
US

V. Phone/Fax

Practice location:
  • Phone: 815-977-4095
  • Fax:
Mailing address:
  • Phone: 815-908-9778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: