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NPI Code Detail

MEDICARE: LISA M HODGSON PT

MEDICARE: LISA M HODGSON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist03-346627CT

General Provider Information

NPI Number : 1215907605
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA M HODGSON PT
Provider Business Mailing Address
First Line : 10 TALCOTT NOTCH RD
Second Line : SUITE 101
City : FARMINGTON
State : CT
Zip : 06032-1800
Country : US
Telephone Number : 860-674-1852
Fax Number : 860-674-1937
Provider Business Practice Location Address
First Line : 10 TALCOTT NOTCH RD
Second Line : SUITE 101
City : FARMINGTON
State : CT
Zip : 06032-1800
Country : US
Telephone Number : 860-674-1852
Fax Number : 860-674-1937
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 11/02/2016

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