Healthcare Provider Details

I. General information

NPI: 1609068683
Provider Name (Legal Business Name): ANDREW HOFFMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11521 FISHERS DR
FISHERS IN
46038-1860
US

IV. Provider business mailing address

11521 FISHERS DR
FISHERS IN
46038-1860
US

V. Phone/Fax

Practice location:
  • Phone: 317-842-1188
  • Fax: 317-842-8522
Mailing address:
  • Phone: 317-842-1188
  • Fax: 317-842-8522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002336A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: