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General NPI Number Information
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NPI Number | 1396901963
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Entity Type | Individual
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Provider Name | TIFFANY DANYALE HOPSON LPTA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 2525 MOSELY LANE
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City | DULUTH
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State | GA
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Zip | 30026-2413
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Country | US
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Telephone | 404-328-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 GLENVIEW DR SW
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City | ATLANTA
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State | GA
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Zip | 30331-2413
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Country | US
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Telephone | 404-328-6580
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA001889
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License Number State | GA
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