Individual
CHRISTINE RENEE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
39237 COUNTY ROAD 43, AULT, CO 80610-9539
(970) 692-4369
Mailing address
39237 COUNTY ROAD 43, AULT, CO 80610-9539
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/13/2014
Last updated
06/10/2015
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