Provider Demographics
NPI:1831472729
Name:HOOPES, VANCE PATRICK (DPT)
Entity Type:Individual
Prefix:
First Name:VANCE
Middle Name:PATRICK
Last Name:HOOPES
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 1:2520 E IMPALA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-7033
Mailing Address - Country:US
Mailing Address - Phone:928-537-0248
Mailing Address - Fax:928-537-0251
Practice Address - Street 1:5171 CUB LAKE RD
Practice Address - Street 2:SUITE C 360
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7888
Practice Address - Country:US
Practice Address - Phone:928-537-0248
Practice Address - Fax:928-537-0251
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ95162251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics