Individual
DR. CODY MITCHELL KILLGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 786-6942
Mailing address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 786-1887
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2572
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14931948
CAQH
—
05
—
250009343
—
NV
Enumeration date
07/30/2020
Last updated
04/29/2022
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