Provider Demographics
NPI:1760048243
Name:HOOVER, KATELYN PANNELL (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:PANNELL
Last Name:HOOVER
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:LOUISE
Other - Last Name:PANNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-8912
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:3947 GULF SHORES PKWY STE 260
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-2729
Practice Address - Country:US
Practice Address - Phone:251-943-0803
Practice Address - Fax:251-943-4403
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13892255A2300X
ALPTH9982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer