Provider Demographics
NPI:1083017164
Name:JOSHUA H. HOTTES S.C.
Entity Type:Organization
Organization Name:JOSHUA H. HOTTES S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HOTTES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-882-7753
Mailing Address - Street 1:2861 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-3614
Mailing Address - Country:US
Mailing Address - Phone:618-877-1644
Mailing Address - Fax:618-877-0874
Practice Address - Street 1:2861 MADISON AVE
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-3614
Practice Address - Country:US
Practice Address - Phone:618-877-1644
Practice Address - Fax:618-877-0874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty