MEDICARE: KATIE BETH HOFKES D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5657	MN

General Provider Information

NPI Number	:	1447510441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE BETH HOFKES D.C.

Provider Business Mailing Address
First Line	:	10668 SANCTUARY DR NE
Second Line	:
City	:	BLAINE
State	:	MN
Zip	:	55449-5384
Country	:	US
Telephone Number	:	507-313-9816
Fax Number	:

Provider Business Practice Location Address
First Line	:	23168 SAINT FRANCIS BLVD NW
Second Line	:	SUITE 600
City	:	SAINT FRANCIS
State	:	MN
Zip	:	55070-9805
Country	:	US
Telephone Number	:	763-213-0615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	06/27/2012

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