Provider Demographics
NPI:1881652535
Name:HOOPES, JEREMIAH (DC)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:HOOPES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 S 200 E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-3387
Mailing Address - Country:US
Mailing Address - Phone:435-723-0517
Mailing Address - Fax:435-723-0587
Practice Address - Street 1:770 SO 200 E
Practice Address - Street 2:SUITE 102
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302
Practice Address - Country:US
Practice Address - Phone:435-723-0517
Practice Address - Fax:435-723-0587
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52071761202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor