Basic Information
| Provider Information | |||||||||
| NPI: | 1396040952 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPWOOD | ||||||||
| FirstName: | KYLE | ||||||||
| MiddleName: | STEVEN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 835 SE BISHOP BLVD | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093325106 | ||||||||
| FaxNumber: | 5093345723 | ||||||||
| Practice Location | |||||||||
| Address1: | 1620 SE SUMMIT CT | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093325106 | ||||||||
| FaxNumber: | 5093345723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2011 | ||||||||
| LastUpdateDate: | 01/12/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | P160173482 | WA | Y | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.