Provider Demographics
NPI:1932172343
Name:HOFFMAN, CROWN HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:CROWN
Middle Name:HENRY
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 1:616 COX RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0639
Mailing Address - Country:US
Mailing Address - Phone:704-810-0448
Mailing Address - Fax:704-810-0507
Practice Address - Street 1:616 COX RD
Practice Address - Street 2:SUITE G
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0639
Practice Address - Country:US
Practice Address - Phone:704-810-0448
Practice Address - Fax:704-810-0507
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903307Medicaid
NCV09260Medicare UPIN