Healthcare Provider Details

I. General information

NPI: 1841849577
Provider Name (Legal Business Name): JACQUELYN VERONICA HOEVE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7870W US HIGHWAY 2
MANISTIQUE MI
49854-1599
US

IV. Provider business mailing address

7870W US HIGHWAY 2
MANISTIQUE MI
49854-1599
US

V. Phone/Fax

Practice location:
  • Phone: 906-341-3200
  • Fax:
Mailing address:
  • Phone: 906-341-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501014073
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: