Healthcare Provider Details

I. General information

NPI: 1366721888
Provider Name (Legal Business Name): HOFFMAN FAMILY CHIROPRACTIC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 COX RD
GASTONIA NC
28054-0639
US

IV. Provider business mailing address

616 COX RD
GASTONIA NC
28054-0639
US

V. Phone/Fax

Practice location:
  • Phone: 704-810-0448
  • Fax: 704-810-0507
Mailing address:
  • Phone: 704-810-0448
  • Fax: 704-810-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3452
License Number StateNC

VIII. Authorized Official

Name: DR. CROWN HOFFMAN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 704-810-0448