Provider Demographics
NPI:1467697235
Name:HOOK, TARA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:
Last Name:HOOK
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:ANTONELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:PO BOX 31080
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84130
Mailing Address - Country:US
Mailing Address - Phone:631-385-0207
Mailing Address - Fax:631-385-1272
Practice Address - Street 1:100 NORTH MARIO CAPECCHI DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113
Practice Address - Country:US
Practice Address - Phone:801-662-4949
Practice Address - Fax:801-662-4931
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030909-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist