Provider Demographics
NPI:1689000259
Name:HOOVER, JARED JAMES (DPT)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:JAMES
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MARLKRESS RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2334
Mailing Address - Country:US
Mailing Address - Phone:856-424-5552
Mailing Address - Fax:856-424-5559
Practice Address - Street 1:1111 MARLKRESS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2334
Practice Address - Country:US
Practice Address - Phone:856-424-5552
Practice Address - Fax:856-424-5559
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01342600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist