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General NPI Number Information
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NPI Number | 1093801342
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Entity Type | Organization
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Legal Business Name | LEE W. HODGE D.C. P.A.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1214 HOGAN LN STE 200
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City | CONWAY
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State | AR
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Zip | 72034-8002
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Country | US
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Telephone | 501-329-2774
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1600
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City | CONWAY
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State | AR
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Zip | 72033-1600
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Country | US
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Telephone | 501-329-2774
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. LEE W HODGE
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Credential | D.C.
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Telephone | 501-329-2774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1439
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License Number State | AR
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