Provider Demographics
NPI:1821250986
Name:HOFFERTH-FRANCIS, SAMANTHA GERISE (D C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:GERISE
Last Name:HOFFERTH-FRANCIS
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 CALUMET AVE
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2887
Mailing Address - Country:US
Mailing Address - Phone:219-836-9919
Mailing Address - Fax:219-836-9921
Practice Address - Street 1:9305 CALUMET AVE
Practice Address - Street 2:SUITE A-1
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2887
Practice Address - Country:US
Practice Address - Phone:219-836-9919
Practice Address - Fax:219-836-9921
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001846A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor