Provider Demographics
NPI:1487650610
Name:HOARD, CHRISTINA K (DC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:K
Last Name:HOARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-1638
Mailing Address - Country:US
Mailing Address - Phone:269-685-5486
Mailing Address - Fax:269-585-9711
Practice Address - Street 1:321 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1638
Practice Address - Country:US
Practice Address - Phone:269-685-5486
Practice Address - Fax:269-685-9711
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Z35069OtherMEDICARE ADVANTAGE
950Z350690OtherBCBS
MI3427369Medicaid
MIU25920Medicare UPIN
MI3427369Medicaid