Provider Demographics
NPI:1346002060
Name:HOXIE, JARED BRYAN
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:BRYAN
Last Name:HOXIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 S MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-2386
Mailing Address - Country:US
Mailing Address - Phone:207-631-8617
Mailing Address - Fax:
Practice Address - Street 1:322 S MAIN ST APT 2
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-2386
Practice Address - Country:US
Practice Address - Phone:207-631-8617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer