Individual
SUSAN HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7909 PAT BOOKER RD, LIVE OAK, TX 78233-2602
(210) 590-7412
Mailing address
PO BOX 39691, SAN ANTONIO, TX 78218-6691
(210) 655-2950
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001756
LICENSE #
TX
Enumeration date
08/30/2006
Last updated
11/02/2007
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