MEDICARE: DR. JOSEPH J. HODGES D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2788	OR

General Provider Information

NPI Number	:	1982601696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH J. HODGES D.C.

Provider Business Mailing Address
First Line	:	PO BOX 2722
Second Line	:
City	:	HARBOR
State	:	OR
Zip	:	97415-0325
Country	:	US
Telephone Number	:	541-469-2276
Fax Number	:	541-469-0489

Provider Business Practice Location Address
First Line	:	411 MILL BEACH RD.
Second Line	:	SUITE A
City	:	BROOKINGS
State	:	OR
Zip	:	97415
Country	:	US
Telephone Number	:	541-469-2722
Fax Number	:	541-469-0489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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