Provider Demographics
NPI:1366721888
Name:HOFFMAN FAMILY CHIROPRACTIC, PA
Entity type:Organization
Organization Name:HOFFMAN FAMILY CHIROPRACTIC, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CROWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-810-0448
Mailing Address - Street 1:616 COX RD
Mailing Address - Street 2:
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:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919553Medicaid