Individual
DR. CODY MICHAEL CARLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
20745 N SCOTTSDALE RD STE 110, SCOTTSDALE, AZ 85255-6595
(480) 882-4934
Mailing address
20745 N SCOTTSDALE RD STE 110, SCOTTSDALE, AZ 85255-6595
(480) 882-4934
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
32390
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPT-32390
ARIZONA STATE BOARD OF PHYSICAL THERAPY
AZ
Enumeration date
06/13/2022
Last updated
07/19/2024
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