Healthcare Provider Details

I. General information

NPI: 1407854342
Provider Name (Legal Business Name): NICOLE DANIELLE HOFFMAN MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

IV. Provider business mailing address

7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

V. Phone/Fax

Practice location:
  • Phone: 272-220-6021
  • Fax: 570-600-1144
Mailing address:
  • Phone: 570-837-2123
  • Fax: 570-837-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015858
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: