Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 7525 | TN |
NPI | 1003497462 |
---|---|
Provider Name | Madeline H Hopper |
First Address | Milan, TN 38358-4502 |
Second Address | Ripley, TN 38063-5511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2021 |
Last Update Date | 17/04/2021 |