Doctor Name: | MRS. NICOLE SUSAN HODRICK |
NPI Number: | 1144599663 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMT |
License Number: | MSG002182 |
Business Practice Address: | 1009 Broad Street Montoursville, PA - 17754 |
Business Phone Number: | 5703688389 |
Business Fax Number: | 5703688391 |
Mailing Address: | 1009 Broad Street, MONTOURSVILLE |
State: | PA |
Postal Code: | 17754 |
Phone Number: | 5703688389 |
Fax Number: | 5703688391 |
NPI Enumeration Date: | 12/29/2011 |
NPI Last Update Date: | 12/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MSG002182 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |