Provider Demographics
NPI:1083827265
Name:HOOVER, JUSTIN A (PT)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:A
Last Name:HOOVER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:2812 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6202
Mailing Address - Country:US
Mailing Address - Phone:620-208-7878
Mailing Address - Fax:620-208-7000
Practice Address - Street 1:104 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-3557
Practice Address - Country:US
Practice Address - Phone:785-238-3747
Practice Address - Fax:785-238-5514
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS11-00627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist