Individual
CODY VANKERSCHAEVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
950 S MELLONVILLE AVE, SANFORD, FL 32771-2237
(407) 322-8566
Mailing address
1549 OAKWOOD CT, APOPKA, FL 32703-1579
(407) 509-7807
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29867
FL
Other
Enumeration date
12/21/2019
Last updated
12/21/2019
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