Healthcare Provider Details

I. General information

NPI: 1790093847
Provider Name (Legal Business Name): CASEY EDWARD HOFFMAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 W SCHROCK RD
WESTERVILLE OH
43081-4902
US

IV. Provider business mailing address

756 SUMMERWIND LN
LEWIS CENTER OH
43035-8868
US

V. Phone/Fax

Practice location:
  • Phone: 614-791-8015
  • Fax:
Mailing address:
  • Phone: 419-834-0436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number013040
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: