MARIO DONALD HODGE

MOUNT VERNON, IL
NPI1023369501
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224L00000X Pedorthist
(Licence: IL  212.000161)
Enumeration Date2012-09-25
Last Update Date2012-09-25
Business Address
MR. MARIO DONALD HODGE C.PED
1024 JORDAN ST
MOUNT VERNON, IL 62864-4231
Phone number: 618-242-4442
Mailing Address
MR. MARIO DONALD HODGE C.PED
1024 JORDAN ST
MOUNT VERNON, IL 62864-4231
Phone number: 618-242-4442