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General NPI Number Information
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NPI Number | 1447069059
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Entity Type | Individual
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Provider Name | RYAN HOPP DPT
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Gender | Male
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 1791 MESQUITE AVE
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5648
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Country | US
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Telephone | 928-855-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 3235 SADDLEBACK DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86406-7040
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Country | US
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Telephone | 928-230-8892
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-033974
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License Number State | AZ
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