Individual
CODY DREW MAULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3955 E 12TH ST STE 150, CASPER, WY 82609-3114
(307) 554-7861
Mailing address
2965 E TARPON DR STE 150, MERIDIAN, ID 83642-9007
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1883
WY
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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