Individual
CYNTHIA LODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2031
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
041.301849
IL
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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