Healthcare Provider Details

I. General information

NPI: 1154183937
Provider Name (Legal Business Name): MARAH RAE HOFFMAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 JEWETT ST
MARSHALL MN
56258-2663
US

IV. Provider business mailing address

111 JEWETT ST
MARSHALL MN
56258-2663
US

V. Phone/Fax

Practice location:
  • Phone: 507-532-4355
  • Fax: 507-532-2399
Mailing address:
  • Phone: 507-532-4355
  • Fax: 507-532-2399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7190
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: