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General NPI Number Information
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NPI Number | 1144278201
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Entity Type | Individual
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Provider Name | THOMAS HOOPER PT, MHS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 306 RECOVERY RD
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City | KENNETT
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State | MO
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Zip | 63857-3267
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Country | US
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Telephone | 573-888-9190
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Fax | 573-888-9404
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Provider Business Mailing Address
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Address Line | 306 RECOVERY RD
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City | KENNETT
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State | MO
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Zip | 63857-3267
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Country | US
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Telephone | 573-888-9190
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Fax | 573-888-9404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 02042
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License Number State | MO
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