Individual
CODY SHANE ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, ACSM-CEP
Contact information
Practice address
930 SW ABBEY ST, NEWPORT, OR 97365-4820
(541) 574-4856
(541) 768-9417
Mailing address
3140 ELLIOT ST NW, SALEM, OR 97304-1064
(503) 507-9124
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
1066339
OR
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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