Individual
MR. CODY DONALD SPONHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
875 PRE EMPTION RD, GENEVA, NY 14456-2042
(315) 789-5061
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(315) 789-5061
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
027251
NY
Other
Enumeration date
06/03/2021
Last updated
11/22/2021
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