Individual
KRISTIE HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1124 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5236
(405) 582-2105
Mailing address
440 MERCHANT DR, NORMAN, OK 73069-6470
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2016
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016
PTA LICENSE
OK
Enumeration date
03/17/2021
Last updated
03/17/2021
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