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General NPI Number Information
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NPI Number | 1023209541
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Entity Type | Organization
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Legal Business Name | HOISINGTON FAMILY CHIROPRACTIC, PA
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 1033 1ST ST NE
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City | FARIBAULT
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State | MN
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Zip | 55021-5407
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Country | US
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Telephone | 507-332-8623
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Fax | 507-331-3122
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Provider Business Mailing Address
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Address Line | 1033 1ST ST NE
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City | FARIBAULT
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State | MN
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Zip | 55021-5407
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Country | US
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Telephone | 507-332-8623
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Fax | 507-331-3122
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Authorized Official
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Title or Position | DC
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Name | JASON HOISINGTON
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Credential | DC
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Telephone | 507-332-8623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4720
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License Number State | MN
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