Provider Demographics
NPI:1326686163
Name:HOFFMAN, KYLE B (ATC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:B
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:IL
Mailing Address - Zip Code:61273-7748
Mailing Address - Country:US
Mailing Address - Phone:309-222-3374
Mailing Address - Fax:
Practice Address - Street 1:1025 30TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-2804
Practice Address - Country:US
Practice Address - Phone:563-370-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty