Basic Information
Provider Information
NPI: 1568018398
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOPER
FirstName: DAKOTA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: HOOVER
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 7175651104
Practice Location
Address1: 1000 RV TRCE
Address2:  
City: HOOVER
State: AL
PostalCode: 352448000
CountryCode: US
TelephoneNumber: 2057392069
FaxNumber: 2054601259
Other Information
ProviderEnumerationDate: 08/16/2019
LastUpdateDate: 04/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH9540ALY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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