Provider Demographics
NPI:1922049436
Name:HOFFECKER, MEGAN JOY (ATC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOY
Last Name:HOFFECKER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:JOY
Other - Last Name:CULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:108 JULIA ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-1844
Mailing Address - Country:US
Mailing Address - Phone:401-345-6184
Mailing Address - Fax:
Practice Address - Street 1:108 JULIA ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-1844
Practice Address - Country:US
Practice Address - Phone:401-345-6184
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer