Healthcare Provider Details

I. General information

NPI: 1801812599
Provider Name (Legal Business Name): JAMES DAVID HODGES P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 MOUNT PLEASANT ST SUITE 104
BURLINGTON IA
52601-2002
US

IV. Provider business mailing address

2850 MOUNT PLEASANT ST SUITE 104
BURLINGTON IA
52601-2002
US

V. Phone/Fax

Practice location:
  • Phone: 319-754-6558
  • Fax: 319-754-6512
Mailing address:
  • Phone: 319-754-6558
  • Fax: 319-754-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: