Provider Demographics
NPI:1083227466
Name:HOTZ, SYDNEY (ATC, LAT, NREMT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:HOTZ
Suffix:
Gender:F
Credentials:ATC, LAT, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 W HINES HILL RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1032
Mailing Address - Country:US
Mailing Address - Phone:207-974-9129
Mailing Address - Fax:
Practice Address - Street 1:129 W HINES HILL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1032
Practice Address - Country:US
Practice Address - Phone:207-974-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0060372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer