Healthcare Provider Details

I. General information

NPI: 1841470127
Provider Name (Legal Business Name): HOFFERTH FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 CALUMET AVE SUITE A-1
MUNSTER IN
46321-2887
US

IV. Provider business mailing address

9305 CALUMET AVE SUITE A-1
MUNSTER IN
46321-2887
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-9919
  • Fax: 219-836-9921
Mailing address:
  • Phone: 219-836-9919
  • Fax: 219-836-9921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001623
License Number StateIN

VIII. Authorized Official

Name: DR. JOSEPH G HOFFERTH
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 219-839-9919