Provider Demographics
NPI:1497386163
Name:HINOJOSA, KRISTINA RICHELLE (DC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:RICHELLE
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E WATERLOO RD STE 3
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-8269
Mailing Address - Country:US
Mailing Address - Phone:405-825-4533
Mailing Address - Fax:405-212-4258
Practice Address - Street 1:121 E WATERLOO RD STE 3
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8269
Practice Address - Country:US
Practice Address - Phone:405-825-4533
Practice Address - Fax:405-212-4258
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor