Individual
CODY L MOLDENHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2707 15TH PL, KENOSHA, WI 53140-4947
(262) 551-2700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11813
TN
225100000X
Physical Therapist
Primary
13200-24
WI
225100000X
Physical Therapist
PTL.0013650
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096554
—
WI
Enumeration date
10/02/2015
Last updated
01/26/2026
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