Individual
MARK HOFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
170 N CENTER ST, ORMOND BEACH, FL 32174-5186
(386) 672-7113
Mailing address
158 PINE CONE TRL, ORMOND BEACH, FL 32174-8544
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 21798
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 21798
PTA LICENSE #
FL
Enumeration date
08/12/2009
Last updated
08/12/2009
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