Provider Demographics
NPI:1073735999
Name:HOTCHKISS, EMILY JOY (PT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JOY
Last Name:HOTCHKISS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JOY
Other - Last Name:LUCASSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2961 SAINT ANTHONY DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-5860
Mailing Address - Country:US
Mailing Address - Phone:920-468-0861
Mailing Address - Fax:920-468-0861
Practice Address - Street 1:2961 SAINT ANTHONY DR
Practice Address - Street 2:PARKVIEW MANOR, ATTENTION EMILY PT
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-5860
Practice Address - Country:US
Practice Address - Phone:920-468-0861
Practice Address - Fax:920-569-1566
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10203-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36102900Medicaid