Provider Demographics
NPI:1467127738
Name:507 FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:507 FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-360-6531
Mailing Address - Street 1:100 2ND ST SE STE 2
Mailing Address - Street 2:
Mailing Address - City:STEWARTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55976-1289
Mailing Address - Country:US
Mailing Address - Phone:319-360-6531
Mailing Address - Fax:
Practice Address - Street 1:100 2ND ST SE STE 2
Practice Address - Street 2:
Practice Address - City:STEWARTVILLE
Practice Address - State:MN
Practice Address - Zip Code:55976-1289
Practice Address - Country:US
Practice Address - Phone:319-360-6531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty