Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 6669 | AZ |
Y | 2251N0400X | Physical Therapist - Neurology | LPT-006669 | AZ |
NPI | 1427096312 |
---|---|
Provider Name | Mrs. Shelley L Hockensmith |
First Address | Tucson, AZ 85745-9704 |
Second Address | Tucson, AZ 85705-3812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 16/09/2019 |