MEDICARE: HANNAH HOOTEN PT, DPT

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	225100000X	Physical Therapist	2305205758	VA

General Provider Information

NPI Number	:	1568603181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH HOOTEN PT, DPT

Provider Business Mailing Address
First Line	:	17453 JEFFERSON DAVIS HWY
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22026-2244
Country	:	US
Telephone Number	:	703-221-3913
Fax Number	:	703-221-3203

Provider Business Practice Location Address
First Line	:	17453 JEFFERSON DAVIS HWY
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22026-2244
Country	:	US
Telephone Number	:	703-221-3913
Fax Number	:	703-221-3203

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

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	03/11/2009

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