Provider Demographics
NPI:1366978421
Name:SCHOCH, KRYSTAL (DPT)
Entity type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:
Last Name:SCHOCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 N GRANDVIEW LN STE 204
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0877
Mailing Address - Country:US
Mailing Address - Phone:701-751-2020
Mailing Address - Fax:
Practice Address - Street 1:1655 N GRANDVIEW LN STE 204
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0877
Practice Address - Country:US
Practice Address - Phone:701-751-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1470971Medicaid