Provider Demographics
NPI:1356455836
Name:HOCHSTEIN, CHERYL (MSPT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HOCHSTEIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-244-5005
Mailing Address - Fax:515-244-2202
Practice Address - Street 1:3310 SW 9TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-7647
Practice Address - Country:US
Practice Address - Phone:515-244-5005
Practice Address - Fax:515-244-2202
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0451930Medicaid
IA1451930Medicaid
IA4451930Medicaid
IAI14163Medicare ID - Type Unspecified
IA4451930Medicaid