Individual
CODY MATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9200 W LOOMIS RD, FRANKLIN, WI 53132-8887
(414) 529-9200
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15413-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100174888
—
WI
Enumeration date
07/14/2021
Last updated
07/16/2024
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