Individual
CODY ALAN GEORGE WEINGARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
810 E 23RD ST, SIOUX FALLS, SD 57105-2135
(605) 331-5890
Mailing address
39888 460TH ST, SAINT PETER, MN 56082-5016
(507) 327-1001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028168
PROVIDER CODE 22 (RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)
—
Enumeration date
06/01/2017
Last updated
06/01/2017
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