Provider Demographics
NPI:1144290370
Name:HOEFERT, CODY LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:CODY
Middle Name:LYNN
Last Name:HOEFERT
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 1:909 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:ROCK RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:51246-1905
Mailing Address - Country:US
Mailing Address - Phone:712-472-4732
Mailing Address - Fax:712-472-4734
Practice Address - Street 1:909 S UNION ST
Practice Address - Street 2:
Practice Address - City:ROCK RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:51246-1905
Practice Address - Country:US
Practice Address - Phone:712-472-4732
Practice Address - Fax:712-472-4734
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0434753Medicaid
IA0445189Medicaid
IA20026OtherBCBS OF IOWA
IA34836OtherSIOUX VALLEY
IA493943300OtherMN HEALTHCARE PLANS
IA9936OtherAVERA
IA0445189Medicaid
IA0434753Medicaid
IA20026OtherBCBS OF IOWA