Provider Demographics
NPI:1013364629
Name:HOFFMAN, JULIE (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 E CAVALIER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1913
Mailing Address - Country:US
Mailing Address - Phone:602-743-5483
Mailing Address - Fax:
Practice Address - Street 1:907 E CAVALIER DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1913
Practice Address - Country:US
Practice Address - Phone:602-743-5483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040085225100000X
AZ5312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist