Healthcare Provider Details
I. General information
NPI: 1427054121
Provider Name (Legal Business Name): KEITH C HOBBS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
915 S DORT HWY
FLINT MI
48503-2800
US
IV. Provider business mailing address
915 S DORT HWY STE L
FLINT MI
48503-2800
US
V. Phone/Fax
- Phone: 810-234-3351
- Fax: 810-234-9204
- Phone: 810-234-3351
- Fax: 810-234-9204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | KH004818 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: