Healthcare Provider Details

I. General information

NPI: 1568468320
Provider Name (Legal Business Name): CHRISTIAN MARK HOFFMAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 WOODMAN DR
DAYTON OH
45432-1400
US

IV. Provider business mailing address

1010 WOODMAN DR
DAYTON OH
45432-1400
US

V. Phone/Fax

Practice location:
  • Phone: 937-424-2215
  • Fax: 937-252-1224
Mailing address:
  • Phone: 937-424-2215
  • Fax: 937-252-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9177
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: