MEDICARE: HART PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center		SD

General Provider Information

NPI Number	:	1083616536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HART PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	50 MINNESOTA ST
Second Line	:	SUITE 2
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6217
Country	:	US
Telephone Number	:	605-342-3110
Fax Number	:	605-342-3120

Provider Business Practice Location Address
First Line	:	50 MINNESOTA ST
Second Line	:	SUITE 2
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6217
Country	:	US
Telephone Number	:	605-342-3110
Fax Number	:	605-342-3120

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	MR. RYAN C HANSEN
Credential	:	DPT
Telephone Number	:	605-342-3110

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/21/2022

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