Provider Demographics
NPI:1346738283
Name:HOCKEMEYER, JASON SCOTT (DPT, PT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:SCOTT
Last Name:HOCKEMEYER
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SCHOOLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-1145
Mailing Address - Country:US
Mailing Address - Phone:989-837-1529
Mailing Address - Fax:989-837-2499
Practice Address - Street 1:2600 N SAGINAW RD STE C
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2690
Practice Address - Country:US
Practice Address - Phone:989-837-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist