Basic Information
| Provider Information | |||||||||
| NPI: | 1619504974 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPKINS | ||||||||
| FirstName: | JEREMY | ||||||||
| MiddleName: | NELSON | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5600 LIBERTY WOODS DR | ||||||||
| Address2: | |||||||||
| City: | LIBERTY TWP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450119783 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136850949 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16095 PROSPERITY DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | NOBLESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460604320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136850949 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2020 | ||||||||
| LastUpdateDate: | 03/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 08003141A | IN | Y | Chiropractic Providers | Chiropractor |
No ID Information.