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1174737613
MATTHEW C DODGE
SCOTTSBLUFF, NE
NPI
1174737613
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NE P-328)
Enumeration Date
2007-05-10
Last Update Date
2007-07-08
Business Address
MATTHEW C DODGE PLMHP
4110 AVENUE D
SCOTTSBLUFF, NE 69361-4650
Phone number: 308-635-3171
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Mailing Address
MATTHEW C DODGE PLMHP
4110 AVENUE D
SCOTTSBLUFF, NE 69361-4650
Phone number: 308-635-3171
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