MEDICARE: TERRA C HODGES

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
1	225200000X	Physical Therapy Assistant	PTA18578	FL

General Provider Information

NPI Number	:	1285827436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRA C HODGES

Provider Business Mailing Address
First Line	:	8289 STEWARD CT
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-6851
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8289 STEWARD CT
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-6851
Country	:	US
Telephone Number	:	352-585-6395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	08/21/2007

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Directions to “ TERRA C HODGES ” Practice Location

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