Provider Demographics
NPI:1548021603
Name:HOFFNER, LEAH (DC011897)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HOFFNER
Suffix:
Gender:F
Credentials:DC011897
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5840 STATE ROUTE 981 STE 101
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5398
Mailing Address - Country:US
Mailing Address - Phone:724-240-3016
Mailing Address - Fax:
Practice Address - Street 1:5840 STATE ROUTE 981 STE 101
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5398
Practice Address - Country:US
Practice Address - Phone:724-240-3016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor