Healthcare Provider Details

I. General information

NPI: 1528057924
Provider Name (Legal Business Name): JOANNE PATRICIA HOPPER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6022 W 48TH AVE
AMARILLO TX
79109-7504
US

IV. Provider business mailing address

6402 W CHENOT DR
AMARILLO TX
79109-6580
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-5244
  • Fax:
Mailing address:
  • Phone: 806-358-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1048320
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: