Healthcare Provider Details

I. General information

NPI: 1538434519
Provider Name (Legal Business Name): JESSICA L HOFFMAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 03/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 S MAIN ST
NEW LEXINGTON OH
43764-1376
US

IV. Provider business mailing address

2025 MELON HILL RD NE
NEW LEXINGTON OH
43764-9080
US

V. Phone/Fax

Practice location:
  • Phone: 740-684-1346
  • Fax:
Mailing address:
  • Phone: 740-684-1346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.007511
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: