Individual
CODY CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 E SUMMIT DR APT B16, MARYVILLE, MO 64468-3648
(641) 203-4515
Mailing address
324 E SUMMIT DR APT B16, MARYVILLE, MO 64468-3648
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
01/30/2017
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