Provider Demographics
NPI:1831374206
Name:HOFER, BETH ANN (PT)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:HOFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8437 STATE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1851
Mailing Address - Country:US
Mailing Address - Phone:913-299-9616
Mailing Address - Fax:913-299-9617
Practice Address - Street 1:8437 STATE AVE
Practice Address - Street 2:STE B
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1842
Practice Address - Country:US
Practice Address - Phone:913-299-9616
Practice Address - Fax:913-299-9617
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist