Basic Information
| Provider Information | |||||||||
| NPI: | 1306056577 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HODGDON | ||||||||
| FirstName: | FRANCIS | ||||||||
| MiddleName: | MARY | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1313 STILLWOOD CHASE NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303062500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048757221 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1669 PHOENIX PKWY | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | COLLEGE PARK | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303495464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709071023 | ||||||||
| FaxNumber: | 7709075608 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT000425 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.