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1386691632
TRAVIS DALE HODGSON
OLIVE BRANCH, MS
NPI
1386691632
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MS PTA3566)
Enumeration Date
2006-05-30
Last Update Date
2007-07-08
Business Address
Mr. TRAVIS DALE HODGSON PTA
7501 GOODMAN RD SUITE I
OLIVE BRANCH, MS 38654
Phone number: 662-890-3382
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Mailing Address
Mr. TRAVIS DALE HODGSON PTA
9100 CHAMPLAIN DR
OLIVE BRANCH, MS 38654
Phone number: 662-893-7570
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