Provider Demographics
NPI:1285951541
Name:HOSKINS, DWAYNE ALLEN (DC)
Entity type:Individual
Prefix:
First Name:DWAYNE
Middle Name:ALLEN
Last Name:HOSKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ROTH CT.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46065
Mailing Address - Country:US
Mailing Address - Phone:765-379-2139
Mailing Address - Fax:866-355-9556
Practice Address - Street 1:130 ROTH CT.
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46065
Practice Address - Country:US
Practice Address - Phone:765-379-2139
Practice Address - Fax:866-355-9556
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002109A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor