Individual
LEON CARROLL COODY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-2673
Mailing address
19670 US HIGHWAY 20, BRISTOL, IN 46507-8945
(574) 536-8051
(574) 343-1990
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71007856A
IN
Other
Enumeration date
01/20/2018
Last updated
08/08/2023
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