Healthcare Provider Details

I. General information

NPI: 1174172746
Provider Name (Legal Business Name): ERIC HOFFER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 QUALITY BLVD STE B
FAIRFIELD OH
45014-2289
US

IV. Provider business mailing address

7567 CENTRAL PARKE BLVD STE A
MASON OH
45040-6855
US

V. Phone/Fax

Practice location:
  • Phone: 513-874-1999
  • Fax:
Mailing address:
  • Phone: 513-701-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-018333
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: