Healthcare Provider Details

I. General information

NPI: 1265642441
Provider Name (Legal Business Name): JEFFREY N HOFFMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8129 DELMAR BLVD SUITE 203
SAINT LOUIS MO
63130-3739
US

IV. Provider business mailing address

8129 DELMAR BLVD SUITE 203
SAINT LOUIS MO
63130-3739
US

V. Phone/Fax

Practice location:
  • Phone: 314-721-9900
  • Fax:
Mailing address:
  • Phone: 314-721-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006584
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: