Provider Demographics
NPI:1902470313
Name:HOAR, MACKENZIE KAITLYN (DC)
Entity type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:KAITLYN
Last Name:HOAR
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 1:9531 FIELDS ERTEL RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7320
Mailing Address - Country:US
Mailing Address - Phone:513-640-4500
Mailing Address - Fax:
Practice Address - Street 1:9531 FIELDS ERTEL RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7320
Practice Address - Country:US
Practice Address - Phone:513-640-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor