Organization
CODY'S CENTER OF HOPE, DEDICATED PEDIATRIC CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI R HOLTZMAN (PRESIDENT)
(901) 350-2639
Entity
Organization
Contact information
Practice address
2565 HORIZON LAKE DR STE 114, MEMPHIS, TN 38133-8113
(901) 350-2639
(901) 249-4563
Mailing address
PO BOX 381442, GERMANTOWN, TN 38183-1442
(901) 350-2639
(901) 249-4563
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3496002
—
TN
05
—
4350171
—
TN
Enumeration date
05/01/2018
Last updated
03/22/2022
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