Provider Demographics
NPI:1184020497
Name:HOFFMAN SPORTS CHIROPRACTIC
Entity Type:Organization
Organization Name:HOFFMAN SPORTS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-213-1246
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46082-0410
Mailing Address - Country:US
Mailing Address - Phone:317-213-1246
Mailing Address - Fax:317-842-8522
Practice Address - Street 1:11521 FISHERS DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1860
Practice Address - Country:US
Practice Address - Phone:317-213-1246
Practice Address - Fax:317-842-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002336A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty