# CODY WALKUP

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114467131
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 113044 | IA | Yes |
| 225100000X | Physical Therapist | 11771 | MN | — |
| 225100000X | Physical Therapist | 62149 | OR | — |

## Other

- **Enumeration date:** 02/24/2017
- **Last updated:** 08/17/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1114467131 | — | MN |