Individual
CODY LEEWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
250 NAT TURNER BLVD S, NEWPORT NEWS, VA 23606-3074
(877) 202-9130
Mailing address
250 NAT TURNER BLVD S, NEWPORT NEWS, VA 23606-3074
(757) 596-1900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211870
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14269494
—
VA
01
—
2305211870
PHYSICAL THERAPY LICENSE
VA
Enumeration date
06/19/2018
Last updated
06/19/2018
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