Provider Demographics
NPI:1033505441
Name:HOGAN, JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:HOGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 E PARKER RD
Mailing Address - Street 2:#2
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7377
Mailing Address - Country:US
Mailing Address - Phone:248-291-4983
Mailing Address - Fax:
Practice Address - Street 1:7611 E PARKER RD
Practice Address - Street 2:#2
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7377
Practice Address - Country:US
Practice Address - Phone:248-291-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONOT ISSUED YET111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor