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Individual

MR. CODY A YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
18 E KANSAS CITY ST #101, RAPID CITY, SD 57701-2971
(605) 348-9530
(605) 737-0874
Mailing address
18 E KANSAS CITY ST #101, RAPID CITY, SD 57701-2971
(605) 348-9530
(605) 737-0874

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0860
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5831313
SD
Enumeration date
12/06/2005
Last updated
12/12/2021
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