Provider Demographics
NPI:1841470127
Name:HOFFERTH FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:HOFFERTH FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOFFERTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-839-9919
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN610415OtherUHC
IN000000091520OtherANTHEM BCBS
IN2732113OtherAETNA HMO
IN234906OtherHARMONY HEALTH PLAN
IN7583307OtherAETNA NON HMO
IL90000752OtherBCBS OF IL
IN7583307OtherAETNA NON HMO
IN2732113OtherAETNA HMO