Provider Demographics
NPI:1689992166
Name:DR.JOSEPH J. HODGES PC
Entity Type:Organization
Organization Name:DR.JOSEPH J. HODGES PC
Other - Org Name:HODGES CHIROPRACTIC AND SPORTS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-469-2276
Mailing Address - Street 1:PO BOX 2276
Mailing Address - Street 2:
Mailing Address - City:HARBOR
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0309
Mailing Address - Country:US
Mailing Address - Phone:541-469-2276
Mailing Address - Fax:541-469-0489
Practice Address - Street 1:411 MILL BEACH ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-0325
Practice Address - Country:US
Practice Address - Phone:541-469-2276
Practice Address - Fax:541-469-0489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2788111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty