Individual
MOLLY MARIE HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
360 E MONTVUE DR STE 100, STE 100, MERIDIAN, ID 83642-6318
(208) 855-2900
(208) 855-2911
Mailing address
360 E MONTVUE DR STE 100, MERIDIAN, ID 83642-6318
(541) 914-7632
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4376
ID
225100000X
Physical Therapist
6966
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500650978
—
WA
01
—
P01153277
RR MEDICARE
OR
Enumeration date
09/27/2012
Last updated
04/20/2017
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