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NPI Code Detail

MEDICARE: KATIE ALYSSA HOFER OTR/L

MEDICARE: KATIE ALYSSA HOFER OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist405054CO

General Provider Information

NPI Number : 1912493123
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE ALYSSA HOFER OTR/L
Provider Business Mailing Address
First Line : 9875 PROMINENT PEAK HTS APT 211
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80924-8628
Country : US
Telephone Number : 701-793-3188
Fax Number :
Provider Business Practice Location Address
First Line : 830 TENDERFOOT HILL RD STE 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-7372
Country : US
Telephone Number : 719-623-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2018
Last Update Date : 06/23/2022

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