Provider Demographics
NPI:1245063320
Name:HOEKSTRA, MICHELLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:HOEKSTRA
Suffix:
Gender:X
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5524
Mailing Address - Country:US
Mailing Address - Phone:404-697-9146
Mailing Address - Fax:
Practice Address - Street 1:2226 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-5524
Practice Address - Country:US
Practice Address - Phone:404-697-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist