Healthcare Provider Details

I. General information

NPI: 1669858445
Provider Name (Legal Business Name): HOFFMAN CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 MID RIVERS MALL DR
SAINT PETERS MO
63376-1593
US

IV. Provider business mailing address

355 MID RIVERS MALL DR
SAINT PETERS MO
63376-1593
US

V. Phone/Fax

Practice location:
  • Phone: 636-970-0155
  • Fax:
Mailing address:
  • Phone: 636-970-0155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number2015024929
License Number StateMO

VIII. Authorized Official

Name: DR. JAMES FREDERICK HOFFMAN JR.
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 314-814-5888