MEDICARE: MRS. KARLA JOY HOPPER OTR/L

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	225X00000X	Occupational Therapist	19501317	IA
2	225X00000X	Occupational Therapist	8485	MA
3	225X00000X	Occupational Therapist	7579	CA
4	225X00000X	Occupational Therapist	0747	NV
5	225X00000X	Occupational Therapist	1227	NE
6	225X00000X	Occupational Therapist	004573	GA
7	225X00000X	Occupational Therapist	2007017188	MO
8	225X00000X	Occupational Therapist		IL

General Provider Information

NPI Number	:	1265656441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARLA JOY HOPPER OTR/L

Provider Business Mailing Address
First Line	:	640 GROVE AVE SW # 182
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5759
Country	:	US
Telephone Number	:	563-505-6241
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 GROVE AVE SW # 182
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-5759
Country	:	US
Telephone Number	:	563-505-6241
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	08/10/2007

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