Healthcare Provider Details

I. General information

NPI: 1548191976
Provider Name (Legal Business Name): AMY LYNN HOFFMAN TRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E 600 N
PRICE UT
84501-2126
US

IV. Provider business mailing address

250 E 600 N
PRICE UT
84501-2126
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-2621
  • Fax:
Mailing address:
  • Phone: 435-637-2621
  • Fax: 435-637-8979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number14288425-4003
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: