Provider Demographics
NPI:1326383324
Name:HOFER, CRISTOFER
Entity Type:Individual
Prefix:
First Name:CRISTOFER
Middle Name:
Last Name:HOFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 ELK CREEK LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-3740
Mailing Address - Country:US
Mailing Address - Phone:702-809-9388
Mailing Address - Fax:
Practice Address - Street 1:6560 ELK CREEK LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89156-3740
Practice Address - Country:US
Practice Address - Phone:702-809-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-01
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty