Provider Demographics
NPI:1558658542
Name:HOOVER, PATRICIA SUSAN (LMT, CCP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:SUSAN
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LMT, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12119 PILOT COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34610-7911
Mailing Address - Country:US
Mailing Address - Phone:813-778-4921
Mailing Address - Fax:813-996-1297
Practice Address - Street 1:12625 RACE TRACK RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1331
Practice Address - Country:US
Practice Address - Phone:813-778-4921
Practice Address - Fax:813-996-1297
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55688225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist