Provider Demographics
NPI:1699537290
Name:HOFFMAN, TIMOTHY C (LMT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:TIMOTHY
Other - Middle Name:C
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1045 BIG VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1010
Mailing Address - Country:US
Mailing Address - Phone:719-310-6330
Mailing Address - Fax:
Practice Address - Street 1:1490 W FILLMORE ST STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-1184
Practice Address - Country:US
Practice Address - Phone:719-310-6330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0024895225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty