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Individual

JODI HOFSTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
16639 HOLLAND AVE, SOUTH HOLLAND, IL 60473-2845
(708) 705-4943
(708) 596-8540
Mailing address
16639 HOLLAND AVE, SOUTH HOLLAND, IL 60473-2845
(708) 705-4943
(708) 596-8540

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
JH18760402A
IL

Other

Enumeration date
01/02/2008
Last updated
01/02/2008
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