Individual
PRESTON RODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17861 PRAIRIE SKY WAY, EDMOND, OK 73012-6628
(405) 318-9066
Mailing address
17861 PRAIRIE SKY WAY, EDMOND, OK 73012-6628
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B14389192
—
OK
Enumeration date
07/06/2020
Last updated
07/06/2020
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