Provider Demographics
NPI:1235685132
Name:HOBIN, RICHARD II (COTA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:HOBIN
Suffix:II
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-1750
Mailing Address - Country:US
Mailing Address - Phone:618-444-2532
Mailing Address - Fax:
Practice Address - Street 1:545 HILLCREST ST
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-1750
Practice Address - Country:US
Practice Address - Phone:618-444-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313M0000X313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility