Basic Information
| Provider Information | |||||||||
| NPI: | 1699005850 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOFFMAN | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2556 14 1/2 AVE SE | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563049539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202827599 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13150 1ST ST | ||||||||
| Address2: | |||||||||
| City: | BECKER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553089320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3205978999 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2010 | ||||||||
| LastUpdateDate: | 05/12/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 5458 | MN | Y | Chiropractic Providers | Chiropractor |
No ID Information.