Provider Demographics
NPI:1467610535
Name:HOFFMAN, JENNIFER LOGAN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOGAN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 FALLSTAFF CT
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6274
Mailing Address - Country:US
Mailing Address - Phone:410-552-3657
Mailing Address - Fax:
Practice Address - Street 1:1393 PROGRESS WAY
Practice Address - Street 2:SUITE 907
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6472
Practice Address - Country:US
Practice Address - Phone:410-549-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist