Individual
CODY LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6099 RIVERSIDE DR STE 207, DUBLIN, OH 43017-2004
(330) 383-2512
Mailing address
6099 RIVERSIDE DR STE 207, DUBLIN, OH 43017-2004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA012306
OH
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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