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General NPI Number Information
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NPI Number | 1811484173
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Entity Type | Organization
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Legal Business Name | HOOPER PREVENTATIVE EYECARE CLINIC INC.
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Dates
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Enumeration Date | 04/21/2018
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 19358 DETROIT RD STE A
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City | ROCKY RIVER
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State | OH
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Zip | 44116-1802
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Country | US
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Telephone | 440-799-4311
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Fax | 440-398-8040
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Provider Business Mailing Address
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Address Line | 19358 DETROIT RD STE A
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City | ROCKY RIVER
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State | OH
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Zip | 44116-1802
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Country | US
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Telephone | 440-799-4311
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Fax | 440-398-8040
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. RYAN E. HOOPER
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Credential | OD
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Telephone | 440-799-4311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 6285-T3201
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License Number State | OH
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