Provider Demographics
NPI:1487870358
Name:HINZ, DAVID GERHARD (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GERHARD
Last Name:HINZ
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:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:RUSHFORD
Mailing Address - State:MN
Mailing Address - Zip Code:55971-0601
Mailing Address - Country:US
Mailing Address - Phone:507-864-8888
Mailing Address - Fax:507-864-8889
Practice Address - Street 1:310 SOUTH MILL STREET
Practice Address - Street 2:#107
Practice Address - City:RUSHFORD
Practice Address - State:MN
Practice Address - Zip Code:55971-0601
Practice Address - Country:US
Practice Address - Phone:507-864-8888
Practice Address - Fax:507-864-8889
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4212193-00Medicaid
MN4212193-00Medicaid