Provider Demographics
NPI:1326462755
Name:HOPP, ELIZABETH (LPTA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HOPP
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3398 WATERFORD RD APT A
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-6989
Mailing Address - Country:US
Mailing Address - Phone:740-516-5347
Mailing Address - Fax:
Practice Address - Street 1:3398 WATERFORD RD APT A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-6989
Practice Address - Country:US
Practice Address - Phone:740-516-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05676225200000X
FL24650225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24650OtherLICENSE NUMBER
OH05676OtherLICENSE NUMBER