Healthcare Provider Details
I. General information
NPI: 1730250960
Provider Name (Legal Business Name): MARIA E HOKSBERGEN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 OLD PECOS TRL STE G
SANTA FE NM
87505-4759
US
IV. Provider business mailing address
2900 CORTE DEL POZO
SANTA FE NM
87505-6711
US
V. Phone/Fax
- Phone: 505-954-9940
- Fax: 505-954-9946
- Phone: 505-660-7756
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: