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Mr. Mario Donald Hodge, CPED
Pedorthist in Mount Vernon, Illinois
NPI 1023369501

Mario Donald Hodge is a Pedorthist based in Mount Vernon, IL. Mario Donald Hodge practices in Mount Vernon, IL and has the professional credentials of CPED. The NPI Number for Mario Donald Hodge is 1023369501 and holds a License No. 212.000161 (Illinois).

The current practice location address for Mario Donald Hodge is 1024 Jordan St, Mount Vernon, IL and can be reached out via phone at 618-242-4442 and via fax at 618-242-3942. You can also correspond with Mario Donald Hodge through the mailing address at 1024 JORDAN ST, MOUNT VERNON, IL - 62864-4231 (mailing address contact number: 618-242-4442).

Location: 1024 Jordan St, Mount Vernon, IL, 62864-4231
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023369501
Provider Name
Mario Donald Hodge
Credential
CPED
Provider Entity Type
Individual
Gender
Male
Address
1024 Jordan St, Mount Vernon, IL, 62864-4231
Phone Number
618-242-4442
Fax Number
618-242-3942
Provider Enumeration Date
09/25/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1024 Jordan St
City
Mount Vernon
State
Illinois
Zip
62864-4231
Phone Number
618-242-4442
Fax Number
618-242-3942
person
Provider Business Mailing Address Details
Address
1024 Jordan St
City
Mount Vernon
State
Illinois
Zip
62864-4231
Phone Number
618-242-4442
Fax Number
618-242-3942
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Pedorthist
Speciality
-
Taxonomy
224L00000X
License No.
212.000161 (Illinois)
Definition
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
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