Provider Demographics
NPI:1871506410
Name:HOFF, MICHELLE J (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:HOFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:J
Other - Last Name:OGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1720 HIGHWAY 59 S
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-4331
Mailing Address - Country:US
Mailing Address - Phone:218-681-4747
Mailing Address - Fax:218-671-2595
Practice Address - Street 1:1720 HIGHWAY 59 S
Practice Address - Street 2:
Practice Address - City:THIEF RIVER FALLS
Practice Address - State:MN
Practice Address - Zip Code:56701-4331
Practice Address - Country:US
Practice Address - Phone:218-681-4747
Practice Address - Fax:218-671-2595
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6406694OtherMEDICA #
MNP00398342OtherRR MEDICARE #
MN27309OtherNDBS #
MN450345227-088OtherAMERICA'S PPO/ARAZ #
MN1048082OtherPREFERRED ONE #
ND51224Medicaid
MNHP66886OtherHEALTHPARTNERS #
MN801S3OGOtherMNBS #