Provider Demographics
NPI:1699892547
Name:HOPPER, NICHOLAS DAVID (CSCS, ATC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:DAVID
Last Name:HOPPER
Suffix:
Gender:M
Credentials:CSCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 HARVEST CIR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4073
Mailing Address - Country:US
Mailing Address - Phone:214-213-5944
Mailing Address - Fax:
Practice Address - Street 1:1366 HARVEST CIR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4073
Practice Address - Country:US
Practice Address - Phone:214-213-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer