Provider Demographics
NPI:1093018335
Name:JOCHIM, KAYSI JO (LMT)
Entity Type:Individual
Prefix:MISS
First Name:KAYSI
Middle Name:JO
Last Name:JOCHIM
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 E MAIN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4042
Mailing Address - Country:US
Mailing Address - Phone:701-595-4617
Mailing Address - Fax:
Practice Address - Street 1:402 E MAIN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4042
Practice Address - Country:US
Practice Address - Phone:701-595-4617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1158225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist