Individual
CODY EUGENE RICKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
2200 FORT JESSE RD STE 230&240, NORMAL, IL 61761-6286
(309) 661-6260
Mailing address
108 W WASHINGTON ST APT C, BLOOMINGTON, IL 61701-3978
(309) 839-6638
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070028959
IL
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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