Provider Demographics
NPI:1396040952
Name:HOPWOOD, KYLE STEVEN (PTA)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:STEVEN
Last Name:HOPWOOD
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 SE BISHOP BLVD
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5512
Mailing Address - Country:US
Mailing Address - Phone:509-332-5106
Mailing Address - Fax:509-334-5723
Practice Address - Street 1:1620 SE SUMMIT CT
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5540
Practice Address - Country:US
Practice Address - Phone:509-332-5106
Practice Address - Fax:509-334-5723
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160173482282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access