Provider Demographics
NPI:1962563288
Name:HOPKINS, JON TYSON (PHD, ATC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:TYSON
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:DR
Other - First Name:TY
Other - Middle Name:
Other - Last Name:HOPKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, ATC
Mailing Address - Street 1:1201 N 560 W
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-5195
Mailing Address - Country:US
Mailing Address - Phone:801-422-1573
Mailing Address - Fax:
Practice Address - Street 1:120B RB
Practice Address - Street 2:BRIGHAM YOUNG UNIVERSITY
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84602-2205
Practice Address - Country:US
Practice Address - Phone:801-422-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6335763-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer