Provider Demographics
NPI:1013462753
Name:HOFFENBACKER, KENDRIK
Entity Type:Individual
Prefix:
First Name:KENDRIK
Middle Name:
Last Name:HOFFENBACKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 N MERIDIAN RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3586
Mailing Address - Country:US
Mailing Address - Phone:406-755-6030
Mailing Address - Fax:
Practice Address - Street 1:690 N MERIDIAN RD
Practice Address - Street 2:SUITE 214
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3586
Practice Address - Country:US
Practice Address - Phone:406-755-6030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT81-0540636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor