Provider Demographics
NPI:1366283541
Name:HOPPER, BARRETT (PT, DPT)
Entity type:Individual
Prefix:
First Name:BARRETT
Middle Name:
Last Name:HOPPER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 LAKE CENTER PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7729
Mailing Address - Country:US
Mailing Address - Phone:770-205-3939
Mailing Address - Fax:770-205-4994
Practice Address - Street 1:5530 WINDWARD PKWY STE 350
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-8972
Practice Address - Country:US
Practice Address - Phone:770-410-1808
Practice Address - Fax:770-410-1838
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT017106225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist