Healthcare Provider Details

I. General information

NPI: 1932313004
Provider Name (Legal Business Name): BECKY KAY HOFFMANN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 S RAPIDS RD
MANITOWOC WI
54220-4146
US

IV. Provider business mailing address

4517 LAURIE LN
TWO RIVERS WI
54241-1039
US

V. Phone/Fax

Practice location:
  • Phone: 920-684-1144
  • Fax: 920-482-0651
Mailing address:
  • Phone: 920-553-3690
  • Fax: 920-482-0651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12895-146
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4920-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: