MEDICARE: CHERYLE HOPPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	7501000044	MI

General Provider Information

NPI Number	:	1134550692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYLE HOPPER

Provider Business Mailing Address
First Line	:	27475 ELLWARD ST
Second Line	:
City	:	ROMULUS
State	:	MI
Zip	:	48174-2901
Country	:	US
Telephone Number	:	734-941-8537
Fax Number	:

Provider Business Practice Location Address
First Line	:	1537 MONROE ST STE 200
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2842
Country	:	US
Telephone Number	:	313-565-9124
Fax Number	:	313-565-9124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	12/10/2013

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Directions to “ CHERYLE HOPPER ” Practice Location

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