Provider Demographics
NPI:1376151209
Name:HOCKENBERRY, MEREDITH RENEE
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:RENEE
Last Name:HOCKENBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 TUSCARORA DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-7004
Mailing Address - Country:US
Mailing Address - Phone:814-251-4069
Mailing Address - Fax:
Practice Address - Street 1:6107 TUSCARORA DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-7004
Practice Address - Country:US
Practice Address - Phone:814-251-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI005001225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty