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Individual
CODY ALAN GEORGE WEINGARTZ
Active
Individual
CODY ALAN GEORGE WEINGARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028168
PROVIDER CODE 22 (RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)
—
Enumeration date
06/01/2017
Last updated
06/01/2017
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