Provider Demographics
NPI:1760538714
Name:HOPPER, PHILIP (PTA)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:HOPPER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762A E GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5017
Mailing Address - Country:US
Mailing Address - Phone:334-501-2290
Mailing Address - Fax:334-501-2293
Practice Address - Street 1:762A E GLENN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5017
Practice Address - Country:US
Practice Address - Phone:334-501-2290
Practice Address - Fax:334-501-2293
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant