Provider Demographics
NPI:1508552415
Name:HODNETT, JOSHUA LANCE (CPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LANCE
Last Name:HODNETT
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4054
Mailing Address - Country:US
Mailing Address - Phone:817-538-1007
Mailing Address - Fax:
Practice Address - Street 1:1353 NORWOOD DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4054
Practice Address - Country:US
Practice Address - Phone:817-538-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No171400000XOther Service ProvidersHealth & Wellness Coach