Provider Demographics
NPI:1417203704
Name:HOCHHALTER, MINDY ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:ANN
Last Name:HOCHHALTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 AUTUMBLAZE WAY
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-8701
Mailing Address - Country:US
Mailing Address - Phone:701-320-1924
Mailing Address - Fax:
Practice Address - Street 1:1655 N GRANDVIEW LN
Practice Address - Street 2:#204
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0877
Practice Address - Country:US
Practice Address - Phone:701-527-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1573225100000X
SD1583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist