MEDICARE: KEITH HOYING

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1952969891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH HOYING

Provider Business Mailing Address
First Line	:	2801 W BANCROFT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 KENSINGTON RD # A
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-1354
Country	:	US
Telephone Number	:	937-622-8410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2019
Last Update Date	:	06/05/2019

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Directions to “ KEITH HOYING ” Practice Location

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