Provider Demographics
NPI:1699005850
Name:HOFFMAN, MATTHEW JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOHN
Last Name:HOFFMAN
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 1:2556 14 1/2 AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56304-9539
Mailing Address - Country:US
Mailing Address - Phone:320-282-7599
Mailing Address - Fax:
Practice Address - Street 1:13150 1ST ST
Practice Address - Street 2:
Practice Address - City:BECKER
Practice Address - State:MN
Practice Address - Zip Code:55308-9320
Practice Address - Country:US
Practice Address - Phone:320-597-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor