Provider Demographics
NPI:1770792863
Name:TOCHOLKE, MARK E (RRT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:TOCHOLKE
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BACON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PARROTTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37843-2580
Mailing Address - Country:US
Mailing Address - Phone:423-623-4638
Mailing Address - Fax:
Practice Address - Street 1:4850 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3098
Practice Address - Country:US
Practice Address - Phone:423-787-6635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3714227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered