Provider Demographics
NPI:1073398038
Name:HOOVER, KOBIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KOBIE
Middle Name:
Last Name:HOOVER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 MOONCOIN WAY APT 11202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6098
Mailing Address - Country:US
Mailing Address - Phone:217-371-9655
Mailing Address - Fax:
Practice Address - Street 1:102 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-1917
Practice Address - Country:US
Practice Address - Phone:859-881-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0088752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic