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NPI Code Detail

MEDICARE: DR. KATIE HOFFMAN ATMATZIDIS OTD, OTR/L

MEDICARE: DR. KATIE HOFFMAN ATMATZIDIS OTD, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist11107NC
2225X00000XOccupational TherapistOTH-007546AZ

General Provider Information

NPI Number : 1427550698
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE HOFFMAN ATMATZIDIS OTD, OTR/L
Provider Business Mailing Address
First Line : 12740 N PLAZA DEL RIO BLVD
Second Line :
City : PEORIA
State : AZ
Zip : 85381-8100
Country : US
Telephone Number : 480-347-6937
Fax Number :
Provider Business Practice Location Address
First Line : 12740 N PLAZA DEL RIO BLVD
Second Line :
City : PEORIA
State : AZ
Zip : 85381-8100
Country : US
Telephone Number : 803-416-9374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2018
Last Update Date : 10/23/2020

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