Healthcare Provider Details

I. General information

NPI: 1780060392
Provider Name (Legal Business Name): KASEY LYNN HOOPES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 W 27TH ST
ASHTABULA OH
44004-4975
US

IV. Provider business mailing address

416 W 27TH ST
ASHTABULA OH
44004-4975
US

V. Phone/Fax

Practice location:
  • Phone: 440-997-5427
  • Fax: 440-997-5486
Mailing address:
  • Phone: 440-997-5427
  • Fax: 440-997-5486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015554
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: