Healthcare Provider Details

I. General information

NPI: 1770792863
Provider Name (Legal Business Name): MARK E. TOCHOLKE R.R.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 E ANDREW JOHNSON HWY
GREENEVILLE TN
37745-3098
US

IV. Provider business mailing address

142 BACON VALLEY RD
PARROTTSVILLE TN
37843-2580
US

V. Phone/Fax

Practice location:
  • Phone: 423-787-6635
  • Fax:
Mailing address:
  • Phone: 423-623-4638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number3714
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: