Individual
CODY NATHAN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
104 MAULDIN RD # TEB, GREENVILLE, SC 29605-1221
(864) 214-6680
(864) 309-8043
Mailing address
104 MAULDIN RD STE B, GREENVILLE, SC 29605-1221
(564) 214-6680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT.10696
SC BOARD OF PT EXAMINERS
SC
Enumeration date
06/07/2022
Last updated
04/20/2026
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