Provider Demographics
NPI:1790093847
Name:HOFFMAN, CASEY EDWARD (DPT)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:EDWARD
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 SUMMERWIND LN
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8868
Mailing Address - Country:US
Mailing Address - Phone:419-834-0436
Mailing Address - Fax:
Practice Address - Street 1:154 W SCHROCK RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4902
Practice Address - Country:US
Practice Address - Phone:614-791-8015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist