Individual
KRISTEN MARIE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 ASHLAND AVE, CLINTON, SC 29325-2960
(864) 347-5707
Mailing address
601 CEDAR STREET, APT 6A, CLINTON, SC 29325
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2178
SC
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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