Basic Information
| Provider Information | |||||||||
| NPI: | 1093734105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOKS | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | RYAN | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1781B COMMONS NORTH LOOP | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354063577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057520845 | ||||||||
| FaxNumber: | 2057520866 | ||||||||
| Practice Location | |||||||||
| Address1: | 1781B COMMONS NORTH LOOP | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354063577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057520845 | ||||||||
| FaxNumber: | 2057520866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 12/31/2013 | ||||||||
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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 | 225100000X | PTH2791 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT-013175 | OH | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 5773741 | 01 | AL | AETNA | OTHER | 51532485 | 01 | AL | BCBS OF AL | OTHER | 890015960 | 05 | AL | MEDICAID |