Healthcare Provider Details

I. General information

NPI: 1093011355
Provider Name (Legal Business Name): ALISA DIANA HOFFMAN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 PINETREE RD STE 101
LANSING MI
48911-4286
US

IV. Provider business mailing address

3400 PINETREE RD STE 101
LANSING MI
48911-4286
US

V. Phone/Fax

Practice location:
  • Phone: 517-574-4291
  • Fax:
Mailing address:
  • Phone: 517-574-4291
  • Fax: 517-574-4725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009895
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: