Healthcare Provider Details

I. General information

NPI: 1770019598
Provider Name (Legal Business Name): GENIE HOPKINS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GENIE WOODARD PT, DPT

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 11/07/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9475 US-19
ZEBULON GA
30295
US

IV. Provider business mailing address

6397 LEE HWY STE 300
CHATTANOOGA TN
37421-4915
US

V. Phone/Fax

Practice location:
  • Phone: 770-567-7500
  • Fax:
Mailing address:
  • Phone: 423-238-7217
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016823
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT014719
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: