Individual
CODY BLACKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, CSCS
Contact information
Practice address
1422 OLD WEISGARBER RD, KNOXVILLE, TN 37909-1293
(865) 680-7965
Mailing address
1734 HALEY GLENN LN, KNOXVILLE, TN 37920-9602
(865) 271-8530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1880
TN
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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