Individual
DR. JUSTIN ROBERT LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8805 N MAIN ST, STE 110, DAYTON, OH 45415-1333
(937) 204-1877
(937) 204-1878
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014355
OH
2251X0800X
Orthopedic Physical Therapist
014355
OH
2251X0800X
Orthopedic Physical Therapist
25667
FL
Other
Enumeration date
07/20/2010
Last updated
05/02/2017
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