Provider Demographics
NPI:1659820967
Name:HOFFMAN, BROOKE (LMT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 KALANIANAOLE HWY STE 207
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1279
Mailing Address - Country:US
Mailing Address - Phone:808-275-7087
Mailing Address - Fax:
Practice Address - Street 1:6700 KALANIANAOLE HWY STE 207
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1279
Practice Address - Country:US
Practice Address - Phone:808-275-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14570225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist