Provider Demographics
NPI:1588017230
Name:HILL, HERBERT HOOVER III
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:HOOVER
Last Name:HILL
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2795 MARKLE LOOP APT B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-4284
Mailing Address - Country:US
Mailing Address - Phone:907-903-2373
Mailing Address - Fax:
Practice Address - Street 1:2795 MARKLE LOOP APT B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4284
Practice Address - Country:US
Practice Address - Phone:907-903-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101891225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist