Healthcare Provider Details

I. General information

NPI: 1679782684
Provider Name (Legal Business Name): TRACY ELIZABETH HOJNOWSKI PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 RURAL AVE
WILLIAMSPORT PA
17701-1669
US

IV. Provider business mailing address

RR 2 BOX 2960
CANTON PA
17724-8641
US

V. Phone/Fax

Practice location:
  • Phone: 570-323-4340
  • Fax: 570-329-3083
Mailing address:
  • Phone: 570-673-4627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE000077L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: