Healthcare Provider Details

I. General information

NPI: 1316133952
Provider Name (Legal Business Name): AMY WILLS HOPPER P.T., D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 LINEBERRY BLVD
MOUNT JULIET TN
37122-5517
US

IV. Provider business mailing address

2000 ARDEN COURT
MOUNT JULIET TN
37122
US

V. Phone/Fax

Practice location:
  • Phone: 615-758-4888
  • Fax: 615-758-6188
Mailing address:
  • Phone: 615-598-0113
  • Fax: 615-758-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7955
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: