Healthcare Provider Details

I. General information

NPI: 1942453642
Provider Name (Legal Business Name): CHRISTINA DIANNE HODGES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2606 E SNEAD AVE
SPOKANE WA
99223-9587
US

IV. Provider business mailing address

1304 E GRANARY CT
SPOKANE WA
99208-7044
US

V. Phone/Fax

Practice location:
  • Phone: 509-209-7429
  • Fax:
Mailing address:
  • Phone: 509-954-0789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: