Provider Demographics
NPI:1922522531
Name:BOCHEK, KESSA LYNN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KESSA
Middle Name:LYNN
Last Name:BOCHEK
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 1:402 NE GRANT ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-1812
Mailing Address - Country:US
Mailing Address - Phone:402-821-7613
Mailing Address - Fax:
Practice Address - Street 1:1325 COCONINO RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7846
Practice Address - Country:US
Practice Address - Phone:515-292-2858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087493225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist