Individual
CODY STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13101 ECKLES RD STE 102, PLYMOUTH, MI 48170-4245
(313) 288-9736
Mailing address
PO BOX 51723, LIVONIA, MI 48151-5723
(586) 634-1189
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703055239
MI
2279H0200X
Home Health Registered Respiratory Therapist
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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