Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 33251 | CA |
NPI | 1093963019 |
---|---|
Provider Name | Ms. Jessica M. Hoinacki |
First Address | Berlin, WI 54923-9486 |
Second Address | Berlin, WI 54923-9486 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 03/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33251 | STATE OF CALIFORNIA (01) | CA |