Individual
BRODERICK HODO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 FOX CHASE DR, HATTIESBURG, MS 39402-2575
(601) 366-1081
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7102
MS
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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