Provider Demographics
NPI:1225642929
Name:HOFFMAN, MADALINE ELYSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MADALINE
Middle Name:ELYSE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W DUVAL RD
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-4207
Mailing Address - Country:US
Mailing Address - Phone:520-648-3132
Mailing Address - Fax:520-648-1861
Practice Address - Street 1:155 W DUVAL RD
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4207
Practice Address - Country:US
Practice Address - Phone:520-648-3132
Practice Address - Fax:520-648-1861
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist