Provider Demographics
NPI:1992869358
Name:HOOVER, TODD ERIC (DC)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:ERIC
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 CHEYENNE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930
Mailing Address - Country:US
Mailing Address - Phone:307-789-0043
Mailing Address - Fax:307-789-0044
Practice Address - Street 1:545 CHEYENNE DR
Practice Address - Street 2:SUITE A
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930
Practice Address - Country:US
Practice Address - Phone:307-789-0043
Practice Address - Fax:307-789-0044
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
649000OtherACN
302675OtherBCBS
T83054Medicare UPIN
649000OtherACN
WYW21447Medicare PIN