Individual
MR. KEVIN DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 827-6026
(309) 820-3745
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 827-6026
(309) 820-3745
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/25/2013
Last updated
10/25/2013
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