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Individual

CODY CLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
1211 FISH HATCHERY RD, MADISON, WI 53715-1909
(608) 252-8000
(608) 288-6496
Mailing address
13326 ROSSMAN DR, FALL CREEK, WI 54742-9486
(715) 450-4800

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8497-26
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427827146
WI
Enumeration date
12/21/2023
Last updated
07/18/2024
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