Provider Demographics
NPI:1306037858
Name:HOHENSTEIN CHIROPRACTIC
Entity Type:Organization
Organization Name:HOHENSTEIN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOHENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-643-8643
Mailing Address - Street 1:707 PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAUK CITY
Mailing Address - State:WI
Mailing Address - Zip Code:53583-1364
Mailing Address - Country:US
Mailing Address - Phone:608-643-8643
Mailing Address - Fax:608-643-4902
Practice Address - Street 1:707 PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:SAUK CITY
Practice Address - State:WI
Practice Address - Zip Code:53583-1364
Practice Address - Country:US
Practice Address - Phone:608-643-8643
Practice Address - Fax:608-643-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3525 012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI=========Medicaid
WIT61662Medicare UPIN
WI=========Medicaid