Healthcare Provider Details

I. General information

NPI: 1093933541
Provider Name (Legal Business Name): KERRIE L HOFFMAN OTR/L, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRIE L WILCE

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 03/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6211
  • Fax: 570-271-6141
Mailing address:
  • Phone: 570-271-6211
  • Fax: 570-271-6141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD442248
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD442148
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC004184L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: