Provider Demographics
NPI:1760057384
Name:HOFER, CHESNEY (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:CHESNEY
Middle Name:
Last Name:HOFER
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:CHESNEY
Other - Middle Name:
Other - Last Name:NAGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 CIRCLE LINE DR
Mailing Address - Street 2:
Mailing Address - City:ONIDA
Mailing Address - State:SD
Mailing Address - Zip Code:57564-2114
Mailing Address - Country:US
Mailing Address - Phone:605-464-0580
Mailing Address - Fax:
Practice Address - Street 1:633 E SIOUX AVE STE 5
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3368
Practice Address - Country:US
Practice Address - Phone:605-494-0257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist