Healthcare Provider Details

I. General information

NPI: 1083311799
Provider Name (Legal Business Name): ASHLEY HOFFMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 SCHILLING DR S STE 500
DUNDAS MN
55019-3948
US

IV. Provider business mailing address

396 SCHILLING DR S STE 500
DUNDAS MN
55019-3948
US

V. Phone/Fax

Practice location:
  • Phone: 507-321-8695
  • Fax: 507-316-0826
Mailing address:
  • Phone: 507-321-8695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number107038
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: