Healthcare Provider Details

I. General information

NPI: 1295996478
Provider Name (Legal Business Name): AMANDA MARIE HOFFMAN R.D., L.D.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 MAIN ST
JOHNSTOWN PA
15901-1601
US

IV. Provider business mailing address

1086 FRANKLIN ST
JOHNSTOWN PA
15905-4305
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-6800
  • Fax: 814-534-6937
Mailing address:
  • Phone: 814-534-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN003247
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: