Individual
CODY CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9611 TRENTMAN RD, FORT WAYNE, IN 46816-3233
(260) 602-4950
Mailing address
9611 TRENTMAN RD, FORT WAYNE, IN 46816-3233
(260) 602-4950
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IN
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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