Provider Demographics
NPI:1649291212
Name:HODGES, MUILIN M (PT)
Entity type:Individual
Prefix:PROF
First Name:MUILIN
Middle Name:M
Last Name:HODGES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42577 LILLIE DR
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-4780
Mailing Address - Country:US
Mailing Address - Phone:337-280-3738
Mailing Address - Fax:
Practice Address - Street 1:233 DOUCET RD
Practice Address - Street 2:SUITE B2
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3403
Practice Address - Country:US
Practice Address - Phone:337-991-9972
Practice Address - Fax:337-991-9974
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01527F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPT LICENSE NUMBEROther01527F