Provider Demographics
NPI:1942636717
Name:HOFFMAN, ALLISON LEIGH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEIGH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:ALLISON
Other - Middle Name:LEIGH
Other - Last Name:KRUCEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 HEDGES STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902
Mailing Address - Country:US
Mailing Address - Phone:419-774-4290
Mailing Address - Fax:419-774-4375
Practice Address - Street 1:255 HEDGES STREET
Practice Address - Street 2:SUITE A
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902
Practice Address - Country:US
Practice Address - Phone:419-774-4290
Practice Address - Fax:419-774-4375
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2905593Medicaid
OHPT-013009OtherOHIO LICENSE NUMBER
OH2905593Medicaid