Provider Demographics
NPI:1447886254
Name:HOFFER, TERESA ELAINE (LMT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ELAINE
Last Name:HOFFER
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 1:7610 HUPP RD
Mailing Address - Street 2:
Mailing Address - City:THORNVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43076-8808
Mailing Address - Country:US
Mailing Address - Phone:614-309-3960
Mailing Address - Fax:
Practice Address - Street 1:176 S 30TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1941
Practice Address - Country:US
Practice Address - Phone:740-344-4447
Practice Address - Fax:740-344-3346
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.019291225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist