Provider Demographics
NPI:1942521612
Name:JOCHUM, REBECCA (CMT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:JOCHUM
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 DALE ST N APT 205
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2314
Mailing Address - Country:US
Mailing Address - Phone:763-458-3855
Mailing Address - Fax:
Practice Address - Street 1:535 COON RAPIDS BLVD NW STE 101
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-3566
Practice Address - Country:US
Practice Address - Phone:763-458-3855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist