Individual
CODY DON CHAMPAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2718 SHERMAN ST APT 216, GRAND PRAIRIE, TX 75051-1066
(817) 994-4444
Mailing address
2718 SHERMAN ST APT 216, GRAND PRAIRIE, TX 75051-1066
(817) 994-4444
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT135288
TX
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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