Healthcare Provider Details

I. General information

NPI: 1992889372
Provider Name (Legal Business Name): REBECCA DIANE HOKE ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA DIANE BAKER ATC

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 COOL CREEK RD
WRIGHTSVILLE PA
17368
US

IV. Provider business mailing address

280 SILVER MAPLE CT
MOUNT WOLF PA
17347-8905
US

V. Phone/Fax

Practice location:
  • Phone: 717-252-1551
  • Fax: 717-252-6219
Mailing address:
  • Phone: 717-755-4147
  • Fax: 717-252-6219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT002292A
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: