NPI 1073147161

Hayden Klockenga, DPT

Practitioner Physical Therapist Mount Vernon, IL

Practice location

Address: 4121 Veterans Memorial Dr, Mount Vernon, IL 62864-6262
Phone: (618) 242-3778

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 070024984 (IL)

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Registry record

NPI: 1073147161
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Feb 2020
Record last updated: 27 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.