Provider Demographics
NPI:1255006003
Name:BOPP, CAROLYN HANNAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:HANNAH
Last Name:BOPP
Suffix:
Gender:F
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 1:3102 RAINBOW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-5804
Mailing Address - Country:US
Mailing Address - Phone:256-543-0717
Mailing Address - Fax:
Practice Address - Street 1:3102 RAINBOW DR STE 200
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-5804
Practice Address - Country:US
Practice Address - Phone:256-543-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH10473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist