Individual
MR. CODY SAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 BUECHEL BANK RD, LOUISVILLE, KY 40225-0001
(502) 452-4110
Mailing address
8611 FENWICK CREEK PL, APT. G, LOUISVILLE, KY 40220-5835
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AT1240
KY
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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