Healthcare Provider Details

I. General information

NPI: 1417333741
Provider Name (Legal Business Name): JAMES HOFFMAN JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 08/10/2015
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: 636-970-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2015024929
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: