Individual
CODY HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
945 DUKE ST, LEBANON, PA 17042-7216
(717) 274-1495
Mailing address
528 MANDARIN LN, ELIZABETHTOWN, PA 17022-7808
(717) 364-9692
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE012132
PA
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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