Individual
JANICE HODGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4116 SHORELINE BLVD, NEW HAVEN, IN 46774-2754
(260) 602-1203
Mailing address
4116 SHORELINE BLVD, NEW HAVEN, IN 46774-2754
(260) 602-1203
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
350011
IN
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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