Individual
MISS KODI MARX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, OT-SC
Contact information
Practice address
1014 SYCAMORE DR, STE. B, DECATUR, GA 30030-1644
(404) 299-1700
(404) 299-1616
Mailing address
4437 PINERIDGE CIR, DUNWOODY, GA 30338-6538
(404) 451-7682
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000673
GA
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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