Individual
CODY PAINTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
43021 6TH AND BOSTON, LUBBOCK, TX 79401
(214) 592-2486
Mailing address
6309 HANCOCK RD, ROWLETT, TX 75089-8251
(214) 592-2486
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
AT5919
TX
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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