=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093534109
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE MARIE HOOPER DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2024
-----------------------------------------------------
Last Update Date | 10/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6355 WALKER LN STE 100
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22310-3238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-797-6900
-----------------------------------------------------
Fax | 571-665-6952
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2513 BEACON HILL RD
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22306-1609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-643-3225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 2305216726
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------