Healthcare Provider Details
I. General information
NPI: 1013176510
Provider Name (Legal Business Name): DR HOFFMAN CHIROPRACT AND MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2008
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3694 SW PACIFIC HWY
HUBBARD OR
97032
US
IV. Provider business mailing address
PO BOX 825
WILSONVILLE OR
97070
US
V. Phone/Fax
- Phone: 503-982-8683
- Fax: 503-214-8188
- Phone: 503-982-8683
- Fax: 503-214-8188
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 273127 |
| License Number State | OR |
VIII. Authorized Official
Name: DR.
AMY
HOFFMAN
Title or Position: OWNER
Credential: DC
Phone: 503-982-8683