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NPI Code Detail

MEDICARE: HODGE CHIROPRACTIC & WELLNESS

MEDICARE: HODGE CHIROPRACTIC & WELLNESS
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
1111N00000XChiropractor30350CA

General Provider Information

NPI Number : 1699983999
Entity Type Code : Organization
Provider Name (Legal Business Name) : HODGE CHIROPRACTIC & WELLNESS
Provider Business Mailing Address
First Line : 8499 OLD REDWOOD HWY
Second Line : SUITE 204
City : WINDSOR
State : CA
Zip : 95492-8056
Country : US
Telephone Number : 707-836-1075
Fax Number : 707-838-9097
Provider Business Practice Location Address
First Line : 8499 OLD REDWOOD HWY
Second Line : SUITE 204
City : WINDSOR
State : CA
Zip : 95492-8056
Country : US
Telephone Number : 707-836-1075
Fax Number : 707-838-9097
Authorized Official
Title or Position : DOCTOR OF CHIROPRACTIC
Name : DR. DERMAN BYERLY HODGE III
Credential : D.C.
Telephone Number : 707-836-1075
Provider Enumeration Date : 05/18/2007
Last Update Date : 02/15/2008

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Directions to “HODGE CHIROPRACTIC & WELLNESS ” Practice Location

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