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Individual
CODY NATHAN PORTER
Active
Individual
CODY NATHAN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT.10696
SC BOARD OF PT EXAMINERS
SC
Enumeration date
06/07/2022
Last updated
06/11/2026
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