Individual
CODY LEE HATTENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3506
(163) 759-5277
Mailing address
15835 W SUPAI DR, GOODYEAR, AZ 85338-3301
(218) 213-2521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S023388
AZ
Other
Enumeration date
05/04/2018
Last updated
08/06/2021
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