Provider Demographics
NPI:1710501259
Name:JEAN K HOFFMAN, DC
Entity Type:Organization
Organization Name:JEAN K HOFFMAN, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HESSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-390-2551
Mailing Address - Street 1:4555 SUGAR BERRY LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1977
Mailing Address - Country:US
Mailing Address - Phone:614-390-2551
Mailing Address - Fax:
Practice Address - Street 1:4555 SUGAR BERRY LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1977
Practice Address - Country:US
Practice Address - Phone:614-390-2551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center