Healthcare Provider Details

I. General information

NPI: 1487701355
Provider Name (Legal Business Name): BETH ANN HOEFS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 1ST AVE N
MAZEPPA MN
55956
US

IV. Provider business mailing address

PO BOX 1
MAZEPPA MN
55956-0001
US

V. Phone/Fax

Practice location:
  • Phone: 507-843-2323
  • Fax: 507-843-2324
Mailing address:
  • Phone: 507-843-2323
  • Fax: 507-843-2324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3411
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: