Provider Demographics
NPI:1578619946
Name:HOVATER, VICKI LEIGH (RPT)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LEIGH
Last Name:HOVATER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 CHAPARRAL DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1014
Mailing Address - Country:US
Mailing Address - Phone:256-766-6805
Mailing Address - Fax:
Practice Address - Street 1:118 HELTON CT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1465
Practice Address - Country:US
Practice Address - Phone:256-760-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL60651Medicare UPIN
AL60651Medicare ID - Type Unspecified