Individual
CODY ALTISON BURNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
178 PRIVATE ROAD 19423, SOUTH POINT, OH 45680-8831
(740) 534-1386
Mailing address
1404 RACE ST STE 302, CINCINNATI, OH 45202-7366
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.181539.MEDS-IV
OH
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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