=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740062322
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHANDLER CHRISTIAN HOFFNER DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2023
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12027 ANTIOCH RD STE F
-----------------------------------------------------
City | TREVOR
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53179-9498
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-862-6001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8082 GRAND RIVER RD
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48114-9341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-295-2200
-----------------------------------------------------
Fax | 877-325-2945
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2301401447
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------