Provider Demographics
NPI:1225370661
Name:HOENIGMAN, JESSICA (PT, MPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HOENIGMAN
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 E ENTERPRISE DR STE 21
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-1443
Mailing Address - Country:US
Mailing Address - Phone:719-470-1722
Mailing Address - Fax:
Practice Address - Street 1:359 E ENTERPRISE DR STE 21
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-1443
Practice Address - Country:US
Practice Address - Phone:719-470-1722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14999225100000X
NCP13350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist