Healthcare Provider Details

I. General information

NPI: 1316098627
Provider Name (Legal Business Name): MR. LEONARD LEE HOFFERT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 02/23/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9897 MONTGOMERY RD
CINCINNATI OH
45242-6424
US

IV. Provider business mailing address

9897 MONTGOMERY RD
MONTGOMERY OH
45242-6424
US

V. Phone/Fax

Practice location:
  • Phone: 513-731-6587
  • Fax: 513-731-0842
Mailing address:
  • Phone: 513-731-6587
  • Fax: 513-731-0842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberS919
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: