Provider Demographics
NPI:1285200477
Name:AMY BETH HOPKINS MPT PC DBA YOUR PERSONAL BEST PT
Entity Type:Organization
Organization Name:AMY BETH HOPKINS MPT PC DBA YOUR PERSONAL BEST PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-403-3555
Mailing Address - Street 1:2500 W WILLIAM CANNON DR STE 409
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5290
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10721 RESEARCH BLVD STE A-150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5694
Practice Address - Country:US
Practice Address - Phone:903-481-9964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty