Provider Demographics
NPI:1396247516
Name:HOHENSEE, CHANCE (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:CHANCE
Middle Name:
Last Name:HOHENSEE
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:FUNK
Mailing Address - State:NE
Mailing Address - Zip Code:68940-0026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 LAKE ST
Practice Address - Street 2:
Practice Address - City:FUNK
Practice Address - State:NE
Practice Address - Zip Code:68940-4083
Practice Address - Country:US
Practice Address - Phone:308-991-7583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty