Healthcare Provider Details

I. General information

NPI: 1922120815
Provider Name (Legal Business Name): JOAN MELISSA HOFFMAN A.T.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 N CENTER RD
SAGINAW MI
48638-5854
US

IV. Provider business mailing address

5705 S BRENNAN RD
HEMLOCK MI
48626-9739
US

V. Phone/Fax

Practice location:
  • Phone: 989-793-1558
  • Fax:
Mailing address:
  • Phone: 989-642-8974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: