Provider Demographics
NPI:1316550353
Name:JOCHUM, CYNDI E (LMT)
Entity Type:Individual
Prefix:
First Name:CYNDI
Middle Name:E
Last Name:JOCHUM
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 1:8713 GRANITE PATH
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6987
Mailing Address - Country:US
Mailing Address - Phone:817-797-6374
Mailing Address - Fax:
Practice Address - Street 1:8713 GRANITE PATH
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6987
Practice Address - Country:US
Practice Address - Phone:817-797-6374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16081225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist