KEITH LODGE

BUTLER, PA
NPI1104084714
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: PA  25 400 761)
Enumeration Date2008-05-30
Last Update Date2017-03-06
Business Address
Mr. KEITH LODGE M.S.Ed
1 HOSPITAL WAY
BUTLER, PA 16001-4670
Phone number: 724-284-4275
Mailing Address
Mr. KEITH LODGE M.S.Ed
10164 SUDBERRY DR
WEXFORD, PA 15090-9576
Phone number: 724-284-4275
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