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General NPI Number Information
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NPI Number | 1841060423
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Entity Type | Individual
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Provider Name | WESLEY HOOVER
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Gender | Male
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Dates
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Enumeration Date | 01/04/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 1703 W MAIN ST STE A
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2721
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Country | US
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Telephone | 501-385-9822
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Fax |
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Provider Business Mailing Address
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Address Line | 809 W 18TH TER
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-7001
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Country | US
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Telephone | 501-385-9822
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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 | 5422
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License Number State | AR
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