Provider Demographics
NPI:1730142928
Name:HOOVER, PATRICIA RAYELLEN (PT)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:RAYELLEN
Last Name:HOOVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 MARKET STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:717-737-1732
Mailing Address - Fax:717-737-1175
Practice Address - Street 1:3507 MARKET ST STE 301
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4310
Practice Address - Country:US
Practice Address - Phone:717-737-1732
Practice Address - Fax:171-737-1175
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006382L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50024427OtherCAPITAL BLUECROSS
PAHO1530547OtherHIGHMARK BLUESHIELD
PA5512488OtherAETNA
PA229461OtherHEALTH AMERCIA
PA229461OtherHEALTH AMERCIA