Individual
CODY MATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 4TH ST, GARRETSON, SD 57030-2006
(605) 594-3466
Mailing address
6416 W 55TH ST, SIOUX FALLS, SD 57106-1957
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1062
SD
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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