Individual
MR. CODY ALLEN PREMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
690 E PLUMB LN, RENO, NV 89502-3563
(775) 322-4650
(775) 322-3137
Mailing address
690 E PLUMB LN, RENO, NV 89502-3563
(775) 322-4650
(775) 322-3137
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/07/2011
Last updated
07/12/2011
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