Provider Demographics
NPI:1386811313
Name:HOFF, LORI ANN (PTA)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:HOFF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 WARM SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-5032
Mailing Address - Country:US
Mailing Address - Phone:920-469-4530
Mailing Address - Fax:
Practice Address - Street 1:2244 WARM SPRINGS CT
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-5032
Practice Address - Country:US
Practice Address - Phone:920-469-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI477-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant