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Individual

KENNETH HOOPER JR.

Active
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Individual

KENNETH HOOPER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
GN-2095-10
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105726000
—
WY
Enumeration date
05/22/2014
Last updated
05/22/2014
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