Healthcare Provider Details

I. General information

NPI: 1174709984
Provider Name (Legal Business Name): VALERIE HODGSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SOMERSET AVE
NORTH DIGHTON MA
02764-1826
US

IV. Provider business mailing address

PO BOX 1255
NORTH DIGHTON MA
02764-0826
US

V. Phone/Fax

Practice location:
  • Phone: 508-822-1135
  • Fax: 508-822-4115
Mailing address:
  • Phone: 508-822-1135
  • Fax: 508-822-4115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number8950
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: VALERIE HODGSON
Title or Position: OWNER
Credential: PT, DPT, LMT
Phone: 508-823-1610