Provider Demographics
NPI:1649401472
Name:HOBBS, CONNIE LUZ (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:LUZ
Last Name:HOBBS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RUTHERFORD RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4530
Mailing Address - Country:US
Mailing Address - Phone:717-503-0669
Mailing Address - Fax:
Practice Address - Street 1:5 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4530
Practice Address - Country:US
Practice Address - Phone:717-503-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1001013225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant