Provider Demographics
NPI:1669661625
Name:HOOSE, PATRICIA JANE (PT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JANE
Last Name:HOOSE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:JANE
Other - Last Name:PUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:306 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-1935
Mailing Address - Country:US
Mailing Address - Phone:870-679-1513
Mailing Address - Fax:870-679-1516
Practice Address - Street 1:306 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-1935
Practice Address - Country:US
Practice Address - Phone:870-679-1513
Practice Address - Fax:870-679-1516
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist