Provider Demographics
NPI:1114746641
Name:HOCKETT, JOSHUA B (MS, ACSM-EP)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:B
Last Name:HOCKETT
Suffix:
Gender:M
Credentials:MS, ACSM-EP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 BRIDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-1565
Mailing Address - Country:US
Mailing Address - Phone:608-416-9338
Mailing Address - Fax:
Practice Address - Street 1:3336 LOOP 306
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5941
Practice Address - Country:US
Practice Address - Phone:608-416-9338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1064161224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty