Provider Demographics
NPI:1922133032
Name:YOCKEY, TODD MICHAEL (PT)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:MICHAEL
Last Name:YOCKEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 SADIE LN
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-9219
Mailing Address - Country:US
Mailing Address - Phone:417-673-0440
Mailing Address - Fax:
Practice Address - Street 1:2660 E 32ND ST
Practice Address - Street 2:SUITE 104
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4305
Practice Address - Country:US
Practice Address - Phone:417-782-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist