Lance Hodge, PT

Individual provider Active NPI Physical Therapist · Madisonville, TN

NPI 1043835283 · NPPES record last updated Jun 13, 2020

Key facts

NPI
1043835283
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
4249 Highway 411 Ste 4
Madisonville, TN 37354-1544
Phone
(423) 442-4034
NPI assigned
Jun 13, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5119TNMDAddiction Medicine (Anesthesiology) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

4249 Highway 411 Ste 4
Madisonville, TN 37354-1544

Mailing address

1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 238-8923

Other providers in Madisonville, TN

All providers in Madisonville, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.