Doctor Name: | MR. JAN HOGSTROM |
NPI Number: | 1891773511 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 994 |
Business Practice Address: | 4516 Arrowhead Ridge Dr Se Rio Rancho, NM - 87124 |
Business Phone Number: | 5058964978 |
Business Fax Number: | |
Mailing Address: | 4516 Arrowhead Ridge Dr Se, RIO RANCHO |
State: | NM |
Postal Code: | 87124 |
Phone Number: | 5058964978 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2006 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 994 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |