MEDICARE: ANDREA LYNN HOCHARD PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	A4467	MD

General Provider Information

NPI Number	:	1821635897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LYNN HOCHARD PTA

Provider Business Mailing Address
First Line	:	12200 ANNAPOLIS RD SUITE 123
Second Line	:
City	:	SUITE 123
State	:	MD
Zip	:	20769-9182
Country	:	US
Telephone Number	:	301-364-9292
Fax Number	:	301-552-9743

Provider Business Practice Location Address
First Line	:	251 NATIONAL HARBOR BLVD
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-1052
Country	:	US
Telephone Number	:	301-364-9292
Fax Number	:	301-552-9743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2019
Last Update Date	:	12/23/2019

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