Basic Information
| Provider Information | |||||||||
| NPI: | 1386983963 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOVER | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6450 CHESHAM AVE NE | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447213505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309336966 | ||||||||
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| Practice Location | |||||||||
| Address1: | 330 SOUTHWEST AVE | ||||||||
| Address2: | |||||||||
| City: | TALLMADGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442782235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306330555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2013 | ||||||||
| LastUpdateDate: | 02/03/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 5893 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.