Provider Demographics
NPI:1437793866
Name:HOFER, BROOKS
Entity Type:Individual
Prefix:
First Name:BROOKS
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 1:11083 CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47012-8516
Mailing Address - Country:US
Mailing Address - Phone:765-580-2725
Mailing Address - Fax:765-230-5003
Practice Address - Street 1:11083 CLOVER DR
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-8516
Practice Address - Country:US
Practice Address - Phone:765-580-2725
Practice Address - Fax:765-230-5003
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017662225100000X
IN05013389A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist