Individual
MR. CAROL JAMES HODGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
880 CAROLINA AVE, SUMTER, SC 29150-2815
(803) 775-5394
Mailing address
880 CAROLINA AVE, SUMTER, SC 29150-2815
(803) 775-5394
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3102
SC
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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