Individual
SAMUEL HODGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1418 COLLEGE DR, MOUNT CARMEL, IL 62863-2638
(618) 317-5256
Mailing address
1418 COLLEGE DR, MOUNT CARMEL, IL 62863-2638
(618) 317-5256
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003541
IL
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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