Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist | ||
Y | 225200000X | Physical Therapy Assistant |
NPI | 1285804815 |
---|---|
Provider Name | Douglas A Hockenberger |
First Address | Traverse City, MI 49684-8965 |
Second Address | Traverse City, MI 49684-8965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2008 |
Last Update Date | 11/03/2008 |