Provider Demographics
NPI:1356309991
Name:HOAGLAND, LEIF JOSHUA (DC)
Entity Type:Individual
Prefix:DR
First Name:LEIF
Middle Name:JOSHUA
Last Name:HOAGLAND
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 1:8502 TWO NOTCH RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6307
Mailing Address - Country:US
Mailing Address - Phone:803-788-8254
Mailing Address - Fax:
Practice Address - Street 1:8502 TWO NOTCH RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6307
Practice Address - Country:US
Practice Address - Phone:803-788-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2551Medicaid
SCCH2551Medicaid