Individual
CODY RYAN HARLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1100 E 5TH ST, ANDERSON, IN 46012-3462
(260) 578-0144
Mailing address
2910 COPPER HILL RUN, FORT WAYNE, IN 46804-3419
(260) 578-0144
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002859A
IN
Other
Enumeration date
10/22/2018
Last updated
12/10/2024
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