Scott Allen Hofstadter
Individual provider Active NPI Physical Therapy Assistant · Ely, MN
NPI 1902303670 · NPPES record last updated Apr 10, 2018
Key facts
- NPI
- 1902303670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A445 (MN)
- Practice address
- 2160 Deer Ridge Rd
Ely, MN 55731-0593 - Phone
- (612) 805-8270
- Fax
- (612) 805-8270
- NPI assigned
- Apr 10, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A445 | MN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A445 | MN | Yes |
Addresses
Primary practice location
2160 Deer Ridge Rd
Ely, MN 55731-0593
Mailing address
PO Box 593
Ely, MN 55731-0593
Phone (612) 805-8270
Other providers in Ely, MN
- Essentia Health Virginia, LLC
- Sara Ann Fetyko
- Kim Noreen Garrett
- Healthy Families Chiropractic PLLC
- Allison Marie Heiman
- Julie Dawn Houle
- David A Jarecki
- Laurel Beth Kaercher
- Andrea Kristen Kannas
- Colleen Kloehn
All providers in Ely, MN · Physical Therapy Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.