Healthcare Provider Details

I. General information

NPI: 1730346420
Provider Name (Legal Business Name): SOFT TISSUE & MYOFASCIAL TREATMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 OAKDALE RD STE 610
MODESTO CA
95355-3365
US

IV. Provider business mailing address

1317 OAKDALE RD STE 610
MODESTO CA
95355-3365
US

V. Phone/Fax

Practice location:
  • Phone: 209-492-0355
  • Fax: 209-521-0955
Mailing address:
  • Phone: 209-492-0355
  • Fax: 209-521-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD ALLAN HOFF
Title or Position: CEO/DIRRECTOR
Credential: LMT
Phone: 209-492-0355