Provider Demographics
NPI:1497965644
Name:YOCHEM, ERIC MATTHEW (MS, PA-C, ATC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MATTHEW
Last Name:YOCHEM
Suffix:
Gender:M
Credentials:MS, PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 E RICHES AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84106-4506
Mailing Address - Country:US
Mailing Address - Phone:801-647-7340
Mailing Address - Fax:
Practice Address - Street 1:1070 E RICHES AVE APT 10
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-4506
Practice Address - Country:US
Practice Address - Phone:801-647-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7458969-4810174400000X
2255A2300X, 390200000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No174400000XOther Service ProvidersSpecialist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program