Provider Demographics
NPI:1588776371
Name:HODGES, MARLA LECOMTE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:LECOMTE
Last Name:HODGES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:ANN
Other - Last Name:LECOMTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT MS
Mailing Address - Street 1:3419 COLONNADE PKWY
Mailing Address - Street 2:#100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3337
Mailing Address - Country:US
Mailing Address - Phone:205-969-7887
Mailing Address - Fax:205-969-7886
Practice Address - Street 1:3419 COLONNADE PKWY
Practice Address - Street 2:#100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3337
Practice Address - Country:US
Practice Address - Phone:205-969-7887
Practice Address - Fax:205-969-7886
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL418961932OtherTRICARE
AL515-97596OtherBCBS
AL51520639OtherBLUE CROSS
AL6400002OtherUNITED HEALTH CARE
AL515-97596OtherBCBS
AL51520639OtherBLUE CROSS
Q13368Medicare UPIN