Provider Demographics
NPI:1265925002
Name:HODGES, DANA RICHARDS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:RICHARDS
Last Name:HODGES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4629 SCOUT ALY
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-5296
Mailing Address - Country:US
Mailing Address - Phone:843-714-8606
Mailing Address - Fax:843-242-0022
Practice Address - Street 1:401 SEACOAST PKWY UNIT D
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8263
Practice Address - Country:US
Practice Address - Phone:843-969-2201
Practice Address - Fax:843-969-2202
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist