Healthcare Provider Details

I. General information

NPI: 1891901989
Provider Name (Legal Business Name): ROBIN SUZANNE HODGES PT, GCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636F E SHIPTON RD
SALINA KS
67401-9322
US

IV. Provider business mailing address

636F E SHIPTON RD
SALINA KS
67401-9322
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-1045
  • Fax: 620-947-5690
Mailing address:
  • Phone: 785-452-1045
  • Fax: 620-947-5690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number11-1232
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: