Individual
CODY GAWLITTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3117 STILLWATER DR, PRESCOTT, AZ 86305-7164
(928) 442-0005
Mailing address
25121 N 103RD AVE, PEORIA, AZ 85383-2785
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
LPT-33176
AZ
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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