Basic Information
Provider Information
NPI: 1205889730
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOFFORD
FirstName: VINCENT
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5000 CHESHIRE LN N
Address2:  
City: PLYMOUTH
State: MN
PostalCode: 554463706
CountryCode: US
TelephoneNumber: 8883339152
FaxNumber:  
Practice Location
Address1: 3224 COLBY AVE
Address2: SUITE B
City: EVERETT
State: WA
PostalCode: 982014381
CountryCode: US
TelephoneNumber: 4252595066
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000XHA00002730WAY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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