Provider Demographics
NPI:1396744553
Name:HOPP-EDWARDS, SANDRA SUE (PT/OWNER)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SUE
Last Name:HOPP-EDWARDS
Suffix:
Gender:F
Credentials:PT/OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2378 8TH AVENUE, BOX 187
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:KS
Mailing Address - Zip Code:67464-8843
Mailing Address - Country:US
Mailing Address - Phone:785-227-2533
Mailing Address - Fax:
Practice Address - Street 1:1015 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-5735
Practice Address - Country:US
Practice Address - Phone:620-241-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100330590AMedicaid
KS059740OtherBLUE CROSS BLUE SHIELD