Provider Demographics
NPI:1922872431
Name:HODAPP, ROBERT CLARENCE (PTA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CLARENCE
Last Name:HODAPP
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4452 OAKVILLE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-2462
Mailing Address - Country:US
Mailing Address - Phone:513-532-2924
Mailing Address - Fax:
Practice Address - Street 1:4452 OAKVILLE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-2462
Practice Address - Country:US
Practice Address - Phone:513-532-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1663225200000X
OHPTA-1663225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant