Provider Demographics
NPI:1316187636
Name:HOFFMAN, JEANNETTE NICOLE (LMT)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:NICOLE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3015
Mailing Address - Country:US
Mailing Address - Phone:614-448-7134
Mailing Address - Fax:
Practice Address - Street 1:3804 FISHINGER BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9551
Practice Address - Country:US
Practice Address - Phone:614-777-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.014894172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist