Individual
CODY MICHAEL MCENANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1732 RAMBLING RILL CIR, STATHAM, GA 30666-3607
(706) 255-6235
Mailing address
1732 RAMBLING RILL CIR, STATHAM, GA 30666-3607
(706) 255-6235
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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