Provider Demographics
NPI:1619041670
Name:HORNSTEIN FAMILY CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:HORNSTEIN FAMILY CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-672-1300
Mailing Address - Street 1:505 DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-4414
Mailing Address - Country:US
Mailing Address - Phone:701-672-1300
Mailing Address - Fax:701-672-1301
Practice Address - Street 1:505 DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-4414
Practice Address - Country:US
Practice Address - Phone:701-672-1300
Practice Address - Fax:701-672-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13457Medicaid
ND06494001OtherBS GROUP NUMBER