Individual
KENNETH HOOPER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 MAIN, LANDER, WY 82514-0638
(513) 460-7241
(307) 332-0131
Mailing address
345 MAIN, PO BOX 638, LANDER, WY 82514-0638
(513) 460-7241
(307) 332-0131
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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