Healthcare Provider Details

I. General information

NPI: 1316603665
Provider Name (Legal Business Name): MR. ANDREW HOVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19455 ROCKSIDE RD
BEDFORD OH
44146-2000
US

IV. Provider business mailing address

19455 ROCKSIDE RD
BEDFORD OH
44146-2000
US

V. Phone/Fax

Practice location:
  • Phone: 440-439-8666
  • Fax:
Mailing address:
  • Phone: 440-439-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: