Individual
MR. THEODORE LEE HUDSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1800 AIRPARK DR, MYRTLE BEACH, SC 29577-1412
(910) 260-9658
Mailing address
7087 TRAILHEAD RD, LELAND, NC 28451-9506
(910) 260-9658
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
094328
GA
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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