Basic Information
| Provider Information | |||||||||
| NPI: | 1912400227 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOVER | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MOT OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 209 STACEY CT | ||||||||
| Address2: | |||||||||
| City: | CULPEPER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 227012055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142432590 | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 RADIO LN | ||||||||
| Address2: | |||||||||
| City: | CULPEPER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 227011521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408253677 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2018 | ||||||||
| LastUpdateDate: | 03/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 0119003971 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.